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Post-traumatic syringomyelia with holocord involvement: a case report.

Idris Amin1, Gavriil Ilizarov1, Nayeema Chowdhury1

  • 1Department of Rehabilitation Medicine, New York University Langone Medical Center, New York, NY, USA.

Spinal Cord Series and Cases
|September 5, 2017
PubMed
Summary

Holocord syringomyelia, a rare spinal cord cyst after injury, can significantly impact function. Early diagnosis and surgical intervention, like syringosubarachnoid shunting, are crucial for recovery in spinal cord injury patients.

Keywords:
Neurological manifestationsSpinal cord

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Area of Science:

  • Neurology
  • Neurosurgery
  • Rehabilitation Medicine

Background:

  • Syringomyelia involves cyst formation within the spinal cord.
  • Post-traumatic syringomyelia, especially holocord type, is rare but increasingly diagnosed with advanced imaging.
  • Holocord syringomyelia following spinal cord injury is exceptionally uncommon.

Purpose of the Study:

  • To present a rare case of holocord syringomyelia after traumatic spinal cord injury.
  • To highlight the diagnostic challenges and treatment outcomes.
  • To emphasize the importance of recognizing this condition in SCI patients.

Main Methods:

  • Case report of a 57-year-old male with a 30-year-old spinal cord injury.
  • Diagnosis confirmed via MRI showing an extensive intramedullary lesion.
  • Treatment involved T6-T7 laminectomy with syringosubarachnoid shunt placement.
  • Post-operative acute inpatient rehabilitation.

Main Results:

  • The patient experienced a rapid decline in left upper extremity function prior to intervention.
  • Imaging revealed a holocord intramedullary lesion from C1 to the conus medullaris.
  • Successful surgical management and intensive rehabilitation led to significant functional recovery.
  • Patient was discharged home with improved function.

Conclusions:

  • Post-traumatic holocord syringomyelia is a rare but significant complication of spinal cord injury.
  • Prompt diagnosis and surgical treatment are vital for functional recovery.
  • Clinicians must maintain a high index of suspicion for syringomyelia in SCI follow-up.