Posttraumatic syringomyelia with paroxysmal episodes of unconsciousness

A 41-year-old man survived 23 years with quadriplegia following a C-5 fracture dislocation. During the last four months of his life he had paroxysmal episodes of unconsciousness. Necropsy disclosed a posttraumatic syrinx. The cyst extended caudally to the midlumbar region and rostrally into the midline of the medulla without communication into the fourth ventricle. Central apnea due to expansion of the cyst in the medullary respiratory centers is postulated as the possible cause of his paroxysmal episodes of unresponsiveness.