Upper cervical myelopathy associated with low CSF pressure

Abstract

A patient who had undergone ventriculoperitoneal shunting developed upper cervical myelopathy. His CSF pressure was markedly low, and deformation of the spinal cord and shrinkage of the subarachnoid space at the upper cervical level were found in radiologic examinations. Ligation of the shunt tube resulted in almost complete recovery. The effect of excessive drainage may have caused the abnormalities.

Syndrome of cerebral spinal fluid hypovolemia

“…3,4,[8][9][10][11][12] Recently, various atypical patients have been reported, including those without headache, 13,14 those with lingering chronic daily headache, 15,16 and those presenting with reversible encephalopathy, 17 cervical myelopathy, 18 or parkinsonism. Spontaneous CSF leakage from a spinal meningeal diverticula or simple dural tear has been suggested as the underlying pathogenic mechanism.…”

A Poorly Known Cerebrospinal Fluid Shunt Complication: Miyazaki Syndrome

“…extra-dural cervical venous plexus, myelopathy, no headache nor any other typical symptom of intracranial hypotension syndrome. We only found 6 cases (tab.1) [6][7][8][9][10][11]. In all of them the cause of the hypotension was over drainage of CSF due to a ventricular-peritoneal shunt (VP shunt).In 5 cases the malfunctioning shunts had no antisiphon system, the case described by Howard [11] didn't include the type of malfunctioning shunt.…”

“…It is characterized by cervical myelopathy, a considerable growth in volume of the venous plexus of the cervical spine, absence of headache or nausea and any other symptom usually associated with intracranial hypotension. This pathology was first described by Miyazaki et al in 1998. [6] We treated one case, which has led us to research the subject in depth.…”

“…This pathology was first described by Miyazaki et al in 1998. [6] We treated one case, which has led us to research the subject in depth. First we reviewed the Literature and then formulated M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT etiopathogenic theories that might explain all the various clinical aspects of this pathology, which we shall refer to as the Miyazaki's syndrome (MS)…”

Cerebral venous overdrainage: an under-recognized complication of cerebrospinal fluid diversion

“…59 Subsequently in 2002 Matsumoto presented a case of cervical radiculomyelopathy in a 69-year-old man with a ventriculoperitoneal shunt that had been placed 2 years earlier and in whom imaging showed an enhanced "extramedullary mass" causing cord compression. 57 The patient's symptoms resolved after removal of the shunt.…”