Spontaneous collapse of syringomyelia
DOI:
https://doi.org/10.59156/revista.v0i0.691Keywords:
Chiari type I, Full spine radiograph, Scoliosis, SyringomyeliaAbstract
Background: the association between Chiari malformation type I (CM), scoliosis and syringomyelia is well known; spontaneous collapse of the syringomyelia cavity is not, which is highly infrequent.
Objectives: to report a case of spontaneous collapse of syringomyelia and to analyze the bibliography on the subject.
Case description: a 4-and-a-half-year-old patient was diagnosed with Chiari malformation type I associated with syringomyelia and scoliosis. The evolution of the syringomyelia cavity and scoliosis was monitored by magnetic resonance imaging (MRI) and spinograms.
Surgery: during the observation, spontaneous resolution of the syringomyelia was evident. Regarding the CM, surgical treatment was decided to control the scoliosis, which progressed despite decompression and was resolved by instrumented arthrodesis.
Conclusion: our case provides information to the literature for understanding the possible natural evolution of syringomyelia.
Downloads
References
Strahle J, Muraszko KM, Kapurch J, Bapuraj JR, Garton HJL, O Maher C. Chiari malformation Type I and syrinx in children undergoing magnetic resonance imaging: Clinical article, J Neurosurg Pediatr, 2011; 8(2): 205-13. DOI: https://doi.org/10.3171/2011.5.PEDS1121
Giner C, Pérez B. Update on the pathophysiology and management of syringomyelia unrelated to Chiari malformation. Neurologia (Engl Ed), 2019; 34(5): 318-25. DOI: https://doi.org/10.1016/j.nrleng.2018.10.004
Milhorat TH, Nishikawa M, et al. Mechanism of cerebellar tonsil herniation in patients with Chiari malformations as guide to clinical management. Acta Neurochir, 2010: 152(7): 1117-27. DOI: https://doi.org/10.1007/s00701-010-0636-3
Guillen A, Costa J. Spontaneous resolution of a Chiari I malformation associated syringomyelia in one child. Acta Neurochir, 2004; 146(2): 187-91. DOI: https://doi.org/10.1007/s00701-003-0177-0
Gardner WJ. Hydrodynamic mechanism of syringomyelia: its relationship to myelocele. J Neurol Neurosurg Psychiatry, 1965; 28(3): 247-59. DOI: https://doi.org/10.1136/jnnp.28.3.247
Ball MJ, Dayan AD. Pathogenesis of syringomyelia. Lancet, 1972; 2: 799-801. DOI: https://doi.org/10.1016/S0140-6736(72)92152-6
Klekamp J. The pathophysiology of syringomyelia–historical overview and current concept. Acta Neurochir (Wien), 2002; 144(7): 649-64. DOI: https://doi.org/10.1007/s00701-002-0944-3
Aboulker J. La syringomyolie et les liquides intra rachidiens. Neurochirurgie, 1979; 25(Suppl 1): 1-44.
Blegvad C, Grotenhuis JA, Juhler M. Syringomyelia: a practical, clinical concept for classification. Acta Neurochir (Wien), 2014; 156(11): 2127-38. DOI: https://doi.org/10.1007/s00701-014-2229-z
Ebersole K, Roonprapunt C. Revision of Chiari decompression for patients with recurrent syrinx. J Clin Neurosci, 2010; 17(8): 1076-9. DOI: https://doi.org/10.1016/j.jocn.2009.11.024
Wen-Shan S, Yen-Yu C, et al. Spontaneous regression of syringomyelia – review of the current aetiological theories and implications for surgery. J Clin Neurosci, 2008, 15(10): 1185-8. DOI: https://doi.org/10.1016/j.jocn.2007.08.017
Mazumder AK, Das S, et al. Spontaneous resolution of Chiari malformation and associated syringomyelia. Neurol India, 2016; 64(6): 1335-6. DOI: https://doi.org/10.4103/0028-3886.193819
Mikulis DJ, Diaz O, Eggelin TK, et al. Variance of the position of the cerebellar tonsils with age: preliminary report. Radiology, 1992; 183(3): 725-8. DOI: https://doi.org/10.1148/radiology.183.3.1584927
Jack CR, Kokmen E, et al. Spontaneous decompression of syringomyelia: magnetic resonance imaging findings. J Neurosurg, 1991; 74(2): 283-6. DOI: https://doi.org/10.3171/jns.1991.74.2.0283
Kastrup A, Nägele T. Case spontaneous resolution of isolated Chiari I malformation. Childs Nerv Syst, 2006: 22(2): 201. DOI: https://doi.org/10.1007/s00381-005-1213-6
Bogdanov EI, Mendelevich EG. Syrinx size and duration of symptoms predict the pace of progressive myelopathy: retrospective analysis of 103 unoperated cases with craniocervical junction malformations and syringomyelia. Clin Neurol Neurosurg, 2002; 104(2): 90-7. DOI: https://doi.org/10.1016/S0303-8467(01)00189-5
Santoro A, Delfini R, Innocenzi G, et al. Spontaneous drainage of syringomyelia. Report of two cases. J Neurosurg, 1993; 79(1): 132-4. DOI: https://doi.org/10.3171/jns.1993.79.1.0132