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[Post-traumatic syringomyelia: What should know the urologist?]
R Caremel1, O Hamel, E Gerardin
1Service d'urologie, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France. romain.caremel@chu-rouen.fr
Post-traumatic syringomyelia (PTS) affects up to 30% of spinal cord injury patients, often presenting with pain and sensory loss years after the initial injury. Surgical intervention may halt motor decline but doesn't typically improve sensory symptoms or pain.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Context:
- Post-traumatic syringomyelia (PTS) occurs in 25-30% of traumatic spinal cord injury (SCI) patients.
- Magnetic resonance imaging (MRI) is the gold standard for diagnosing and monitoring syringomyelia.
- PTS development requires SCI and blocked cerebrospinal fluid (CSF) flow.
Purpose:
- To review the incidence, diagnosis, symptoms, and management of post-traumatic syringomyelia.
- To highlight the diagnostic criteria and clinical presentation of PTS.
- To discuss current understanding of medical and surgical treatment efficacy.
Summary:
- Syringomyelia presents as increased cord signal on MRI, extending beyond the initial lesion.
- Common symptoms include pain, sensory loss, and new neurological deficits above the injury level.
- Urologic procedures increasing abdominal pressure may worsen syrinx cavities.
- Surgical intervention is not standardized but can arrest motor deterioration.
Impact:
- Highlights the significant incidence of PTS after SCI.
- Emphasizes the importance of recognizing new neurological symptoms as potential indicators of PTS.
- Underscores the limited efficacy of current surgical treatments for sensory and pain symptoms in PTS.
- Informs clinical practice regarding the management of PTS in SCI patients.
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