Syringomyelia: Clinical Observations and Experimental Studies

Abstract

Although cavitary lesions of the spinal cord have been recognized for centuries, only recently have effective, noninvasive imaging techniques allowed antemortem diagnosis of this clinical syndrome. Methods of treatment have not been consistently successful in alleviating or reversing the clinical symptoms caused by these cystic lesions. Incomplete understanding of the underlying pathologic basis for the syringes has impeded the development of effective methods of treatment. This review documents historical considerations regarding clinical observations and experimental studies of this entity and the animal models that have been reported for each of the major types of syringomyelia. Recent studies have suggested that development of a relevant animal model of posttraumatic syringomyelia is imminent. Successful development of an experimental model will not only permit definition of the pathogenesis of cyst formation but also provide methods for testing of therapeutic interventions.

Post-Traumatic Syringomyelia

“…Various mechanisms of cystic formation have been suggested, including liquefaction, hematoma formation, myelomalacia, and necrosis. 22,24 The true incidence of PTS is probably higher than that documented in the published literature. These excitatory amino acids act on multiple receptors in neuronal cell membranes, and with excessive activation can trigger an excitotoxic cascade that ultimately leads to cell death.…”

Eph/ephrin Signaling as a Potential Therapeutic Target After Central Nervous System Injury

“…[43,44]). The late phase lasts from weeks to months and is characterized by the formation of a cavity at the lesion site [48,49]. The subacute phase, which begins several days after injury and extends to several weeks, is characterized by axon attempts at re-growth, and the onset of reactive gliosis leading to eventual glial scar formation (for review see refs.…”

Anaesthesia for caesarean section in a patient with syringomyelia and Arnold-Chiari type I malformation

“…2 Syringomyelia shows a prevalence of 8.4 per 100 000 people. The pathogenesis has been the subject of controversy.…”

“…The clinical diagnosis is based on the triad: (1) loss of pain and temperature sensations with preservation of touch sensation over the neck, shoulders and arms, (2) amyotrophy, and (3) thoracic scoliosis. 2 The clinical diagnosis can be confirmed by complementary investigations such as magnetic resonance imaging as the preferred diagnostic procedure. 6 In approximately one third of patients without surgical treatment, the clinical course of syringomyelia and Arnold-Chiari malformation is static.…”