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Communicating Syringomyelia.

Hiroshi Yokota1, Ryo Tamaki1, Tadashi Sugimoto1

  • 1Department of Neurosurgery, Osaka General Medical Center, Osaka, Japan.

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PubMed
Summary

Communicating syringomyelia can occur in patients with hydrocephalus, often linked to the fourth ventricle. A new shunt helped collapse the syrinx, but clinical improvement was not observed in this case.

Keywords:
Communicating syringomyeliaHydrocephalusShunt malfunctionSyringomyeliaVentriculoperitoneal shunt

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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.