Noncommunicating syringomyelia following occlusion of central canal in rats

Milhorat, Thomas H.; Nobandegani, Fariborz; Miller, John I.; Rao, Chandrakant

doi:10.3171/jns.1993.78.2.0274

Cited by 87 publications

(47 citation statements)

References 19 publications

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“…20 There are several ways to produce experimental syringomyelia. Subarachnoid kaolin injection, 7,9,10,15 spinal cord injury, 11,28 a combination of trauma and kaolin injection, 11,28,31 and intraparenchymal kaolin injection 16,21 have been reported to cause a syrinx. From all these methods, the combination of spinal cord injury and cisternal kaolin injection has been shown to be the superior method of syrinx induction.…”

Section: Discussionmentioning

confidence: 99%

Expression of water channel aquaporin-4 during experimental syringomyelia

Aghayev

Bal²,

Rahimli³

et al. 2011

SPI

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Object Aquaporins (aqp) are protein channels providing water transport across cell membranes. The main member of this family expressed in the CNS is aqp-4. The pattern and amount of expression of this channel suggest a dominant role in bulk water movement into the nervous tissue. It has also been shown to play a role in several water balance disorders in the CNS. In this study, the authors investigated the possible role of aqp-4 in syringomyelia. Methods Twenty-five male Wistar-Hannover rats were divided into experimental (20 rats) and control (5 rats) groups. Syringomyelia was induced in the experimental group by kaolin injection into the cisterna magna. Eight weeks later, the animals were killed, and their spinal cords were removed. Central canal dilations were noted in all experimental animals. Immunohistochemistry and Western blot analysis were performed to evaluate aqp-4 expression. Results Both groups demonstrated positive immunoreactive signals to aqp-4. Western blot analysis revealed a slight decrease in the mean aqp-4 value in the experimental group; however, the difference did not reach statistical significance (p > 0.05). Immunohistochemical analysis showed a similar pattern and intensity of aqp-4 staining in both groups. Conclusions The results of this study indicate that aqp-4 most likely does not play a major role in chronic syringomyelia. Its slight downregulation during the initial stage of syrinx formation is possibly a compensatory mechanism. This effect is not present during the late stage of syringomyelia, and aqp-4 is most likely not involved in the pathophysiology of syrinx cavity formation.

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Section: Discussionmentioning

confidence: 99%

Expression of water channel aquaporin-4 during experimental syringomyelia

Aghayev

Bal²,

Rahimli³

et al. 2011

SPI

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“…It is the leading cause of syringomyelia. 48, 49 Other precipitating factors that may convert an asymptomatic CM-I to a symptomatic one or create a de novo syrinx in previously asymptomatic patients are poorly understood and largely unknown.…”

Section: Association Of Increased Bmi With Cm-i In Adultsmentioning

confidence: 99%

Association of increased body mass index with Chiari malformation Type I and syrinx formation in adults

Arnautović

Mužević

Splavski

et al. 2013

JNS

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C hiari malformation Type I as a hindbrain disorder was first described by an Austrian pathologist, Hans Chiari, in 1891. 47,48 It is mainly characterized by a peg-like deformity and elongation of the cerebellar tonsils and their descent of more than 5 mm below the foramen magnum into the spinal canal. This malformation occurs in both pediatric and adult patients. One of the essential elements in the pathophysiology of clinical symptoms in patients with CM-I is an altered flow of CSF at the level of the foramen magnum and its frequent association with the subsequent development of syringomyelia.Decompression of the foramen magnum, reestablishment of CSF flow across the craniocervical junction, and resolution of the syrinx are well-recognized goals of operative treatment in symptomatic patients with CM-I. This treatment usually resolves or at least stabilizes symptoms in the majority of patients.To the best of our knowledge, there has been no previous study of the association between increased BMI and CM-I or the influence of an increasing BMI on the de novo formation of a spinal cord syrinx in adults. We have recognized, investigated, and analyzed this phenomenon in a series of adults with CM-I over the past 8 years. The goal of this paper was to bring to light this interesting and underrecognized association that may contribute to a better understanding of the pathogenesis and treatment of CM-I in adults. Object. In this paper the authors describe an association between increased body mass index (BMI) and Chiari malformation Type I (CM-I) in adults, as well as its relationship to the development of syringomyelia.Methods. In the period between January 2004 and December 2011, the senior author reviewed the data for all CM-I patients with or without syringomyelia and neurological deficit. Analyzed factors included clinical status (headaches and neurological signs), radiological characteristics of syringomyelia (diameter and vertical extent of syrinx), BMI, and relationship of age to BMI, syrinx diameter, and vertical extent of syrinx.Results. Sixty consecutive adults had CM-I, 26 of whom also had syringomyelia. The mean BMI among all patients was 30.35 ± 7.65, which is Class I obesity (WHO), and was similar among patients with or without syringomyelia. Extension of the vertical syrinx was greater in overweight patients (p = 0.027) than in those with a normal body weight. Evidence of de novo syrinx formation was found in 2 patients who gained an average BMI of 10.8 points. After repeated decompression and no change in holocord syrinx width or vertical extent, a reduction in the syrinx was seen after BMI decreased 11.7 points in one individual. No correlation was found between patient age and BMI, age and vertical extension of the syrinx, and age and diameter of the syrinx.Conclusions. An association between increased BMI and CM-I in adults was recognized. Gaining weight may influence the de novo creation of a syrinx in adults who previously had minimally symptomatic or asymptomatic CM-I, and reducing weight can imp...

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“…Several pathophysiological factors are proposed to promote syringomyelia development: 1) reduction of subarachnoid compliance and accentuated pulse pressure in the cervical portion of the spinal subarachnoid space [16,43], 2) increased intrasyrinx pressure [36], 3) pressure gradients within the intramedullary extracellular fluid [23], 4) intrasyrinx fluid pulsation [9], 5) pulsation of the intramedullary arteries [51], and 6) patency of the central canal of the spinal cord [33]. However, because communication between the syrinx and fourth ventricle is usually not found in radiographic or post-mortem studies, it cannot play a role in pathogenesis of most cases of syringomyelia [34,43,45].…”

Section: Discussionmentioning

confidence: 99%

The post–syrinx syndrome: stable central myelopathy and collapsed or absent syrinx

2006

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Among 168 cases with neurologic findings of cervicothoracic syringomyelia and MRI findings of Chiari 1 malformation and/or underdevelopment of the posterior cranial fossa, 15 patients (9.1%) had collapsed, flat syrinxes and 14 patients (8.3%) did not have syrinxes. Both groups of patients had clinical findings of central myelopathy that had been stable for at least 3 years. Magnetic resonance imaging detected atrophy of the cervical spinal cord in both groups and spontaneous communications between the syrinx and the subarachnoid space in 3 patients of the group with collapsed syrinxes. Analysis of these results and review of the literature suggest that patients with clinical signs of syringomyelia and Chiari 1 malformation or underdeveloped posterior fossa, but with small or absent syringomyelitic cavities, have the "postsyrinx" state as a result of spontaneous collapse of distended syrinxes.

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Noncommunicating syringomyelia following occlusion of central canal in rats

Cited by 87 publications

References 19 publications

Expression of water channel aquaporin-4 during experimental syringomyelia

Expression of water channel aquaporin-4 during experimental syringomyelia

Association of increased body mass index with Chiari malformation Type I and syrinx formation in adults

The post–syrinx syndrome: stable central myelopathy and collapsed or absent syrinx

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