Communicating Syringomyelia.

Area of Science:

• Neurology
• Neurosurgery
• Radiology

Background:

• Communicating syringomyelia is a condition where fluid-filled cavities form within the spinal cord.
• It can be associated with hydrocephalus, a condition characterized by excess cerebrospinal fluid in the brain.
• Neuroimaging often reveals a connection between the syrinx and the fourth ventricle.

Observation:

• A 51-year-old woman with a history of neonatal hydrocephalus and a nonfunctioning cerebrospinal fluid shunt presented with progressive bladder dysfunction and scoliosis.
• Neuroimaging showed tetraventricular enlargement and a holocord syrinx.
• Phase contrast magnetic resonance imaging and ventriculography confirmed communication between the syrinx and the fourth ventricle via a dilated central canal.

Findings:

• A de novo ventriculoperitoneal shunt was placed.
• The shunt placement resulted in the collapse of the holocord syrinx.
• Despite syrinx collapse, no apparent improvement in the patient's clinical symptoms was achieved.

Implications:

• Communicating syringomyelia can be a late complication in patients with treated hydrocephalus.
• Shunt revision is often effective in managing communicating syringomyelia.
• Some cases may necessitate surgical interventions like posterior fossa decompression.