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Syringomyelia

Syrinx

 

Syringomyelia is a cyst-like collection of cereberospinal fluid (CSF) that forms in the spinal cord. Over time, it damages the spinal cord.

Causes

 

The fluid-filled cyst is called a syrinx. The spinal fluid buildup may be caused by:

  • Birth defects (especially Chiari malformation, in which part of the brain pushes down onto the spinal cord at the base of the skull)
  • Spinal cord trauma
  • Tumors of the spinal cord

The fluid-filled cyst usually begins in the neck area. It expands slowly, putting pressure on the spinal cord and slowly causing damage.

 

Symptoms

 

There may be no symptoms. If there are symptoms, they may include:

  • Headache
  • Loss of muscle mass (wasting, atrophy), often in the arms and hands
  • Spasms or tightness in the leg or hand and arm muscles
  • Muscle function loss, loss of ability to use arms or legs
  • Numbness that decreases the feeling of pain or temperature; lowers the ability to feel when the skin is being touched; occurs in the neck, shoulders, upper arms, and trunk in a cape-like pattern; and slowly gets worse over time
  • Pain down the arms, neck, or into the middle back or legs
  • Weakness (decreased muscle strength) in the arms or legs

 

Exams and Tests

 

The health care provider will perform a physical exam and ask about the symptoms, focusing on the nervous system. Tests that may be done include:

  • MRI of the head and spine
  • Spinal CT scan with myelogram (may be done when an MRI isn't possible)

 

Treatment

 

The goals of treatment are to stop the spinal cord damage from getting worse and to improve function.

Surgery may be needed to relieve pressure in the spinal cord. Physical therapy may be needed to improve muscle function.

Ventriculoperitoneal shunting may be needed. This is a procedure in which a catheter (thin, flexible tube) is inserted to drain the fluid buildup.

 

Outlook (Prognosis)

 

Without treatment, the disorder may get worse very slowly. Over time, it may cause severe disability.

Surgery usually stops the condition from getting worse. Nervous system function will improve in about half the people who have surgery.

 

Possible Complications

 

Without treatment, the condition may lead to:

  • Loss of nervous system function
  • Permanent disability

Possible complications of surgery include:

  • Infection
  • Other complications of surgery

 

When to Contact a Medical Professional

 

Call your provider if you have symptoms of syringomyelia.

 

Prevention

 

There is no known way to prevent this condition, other than avoiding injuries to the spinal cord. Getting treated right away slows the disorder from getting worse.

 

 

References

Batzdorf U. Syringomyelia. In: Shen FH, Samartzis D, Fessler RG, eds. Textbook of the Cervical Spine. Philadelphia, PA: Elsevier Saunders; 2015:chap 29.

Perron AD, Huff JS. Spinal cord disorders. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 106.

 
  • Central nervous system

    Central nervous system - illustration

    The central nervous system is made up of the brain and spinal cord. The brain functions to receive nerve impulses from the spinal cord and cranial nerves. The spinal cord contains the nerves that carry messages between the brain and the body.

    Central nervous system

    illustration

    • Central nervous system

      Central nervous system - illustration

      The central nervous system is made up of the brain and spinal cord. The brain functions to receive nerve impulses from the spinal cord and cranial nerves. The spinal cord contains the nerves that carry messages between the brain and the body.

      Central nervous system

      illustration

    Tests for Syringomyelia

     

       

      Review Date: 5/30/2016

      Reviewed By: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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