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EDITED BY PROFESSOR YASSER METWALLY |
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Classification of syringomyelia |
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Syringomyelia poses special challenges for the clinician because of
its complex symptomatology, uncertain pathogenesis, and multiple
options of treatment. The purpose of old studies was to classify
intramedullary cavities according to their most salient pathological
and clinical features. However the use of a disease-based
classification of syringomyelia facilitates diagnosis and the
interpretation of MR imaging findings and provides a guide to treatment |
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Surgical management of syringomyelia |
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This review discusses the currently available surgical approaches to
spinal syringomyelia that is unrelated to Chiari I malformation or
hindbrain descent. Primary spinal syringomyelia is most commonly
associated with spinal trauma but is also encountered as a sequela to
intradural inflammatory processes (infections or chemical), as a
delayed response to surgical procedures, and in association with
intra- and extradural neoplasms as well as disc protrusions. The
advantages of placing a shunt are its technical simplicity and
immediate reduction of syrinx size; its major disadvantages are the
high rate of failure observed in long-term follow up and the
difficulty in applying this technique in septated cysts. Expansion of
the subarachnoid space with resection of scars has better long-term
results. Patients in whom a syrinx cavity has caused a kyphotic
spinal deformity may need to undergo a procedure in which the
kyphotic deformity is corrected to expand the subarachnoid space.
Cyst obliteration is an experimental approach that cannot be
evaluated at the present time. |
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Pathogenesis of syringomyelia |
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The understanding of the pathogenesis of syringomyelia has been
significantly advanced by the studies of Milhorat, et al.[22-24] On
the basis of detailed histopathological findings, they distinguish
among three types of spinal cord cavities: 1) dilations of the
central canal that communicate directly with the fourth ventricle
(communicating syringes); 2) noncommunicating dilations of the
central canal that arise below a syrinx-free segment of spinal cord;
and 3) extracanalicular syringes that originate in the spinal cord
parenchyma and do not communicate with the central canal. By
correlating with clinical parameters, they were able to associate
these distinct cavitary patterns with different mechanisms of
pathogenesis. Communicating syringes were found in association with
hydrocephalus and were caused by obstruction of CSF circulation
distal to the outlets of the fourth ventricle. |
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Neoplastic syringomyelia: A report of two cases |
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A 5-day-old newborn girl presented with hypertrichosis, skin dimple,
and subcutaneous lipoma. Neurological examination found no
abnormalities. Magnetic resonance (MR) imaging of the tboracolumbar
spine showed spinal dermal sinus, type 11 split cord malformation,
and tethered cord (Figs. 1 and 2). A small terminal syringeal cavity
was also present. Cranial ultrasonography and computed tomography
found no abnormalities. The patient was scheduled for surgery at age
6 months. |
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Downloadable multiple choice questions software |
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A downloadable software featuring 5 full radiological cases with
applied self- checking multiple choice questions on every case, you
can email the result to the author for evaluation and discussion. The
software is a freeware, a gift not to sold. You are free to use the
software for any educational purposes you want and to distribute it
on a non-profit basis. A new version of the software is available
every month and remains available for one month (The available
version now is version 3.5, March 2010), the software version is
changed with the monthly update of the bulletin. |
>>>Click
here to download the current version of the multiple choice
questions software>>> ....(Click
here to get a better idea about this publication)
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Downloadable single case study software |
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A downloadable software featuring a full radiological study of a
single case with a radiological report and a review of literature.
You can email the author from within the software. The software is a
freeware, a gift not to sold. You are free to use the software for
any educational purposes you want and to distribute it on a
non-profit basis. A new version of the software is available every
month and remains available for one month (The available version now
is version 3.5, March 2010), the software version is changed with the
monthly update of the bulletin. |
>>>Click
here to download the current version of the single case study software>>> ....(Click
here to get a better idea about this publication)
|
A downloadable, weekly updated, neurological case with full clinical,
radiological and pathological data. You can email the author from
within the downloaded software. The software is a freeware, a gift
not to sold. You are free to use the software for any educational
purposes you want and to distribute it on a non-profit basis. A new
version of the software is available every week and remains available
for one week, it is updated every Saturday. |
>>>Click
here to download the case of the week software>>>
....(Click
here to get a better idea about this publication)..
The
PDF version | The
Short case version | Archive
of long cases | Archive
of short case | Case
records
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A monthly updated PDF file fully addressing a single topic in the
field of neurology, psychiatry or neurosurgery. The PDF file is
changed with the monthly update of the bulletin. |
>>>Click
here to download the current issue of "topic of the month">>>.....(Click
for an archive of back issues of "topic of the month) ..(Topic
of the month)
>>>
Click
to view the radiological quiz>>> | >>>Click
to download the answer to the quiz>>>
Topic
of the month | Thesis
section | Research
section | Talking
psychiatry | Differential
diagnosis | Case
of the week
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Yasser Metwally, all rights reserved |
