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Syringomyelia
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Syringomyelia

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  • 1. Syringomyelia & Syringobulbia Dr. Osman Sadig Bukhari
  • 2.
    • Fluid filled cavity (syrnx), usually ant. to the
    • central canal, usually in za cervical cord,
    • sometimes extending to za thoracic cord
    • ( syringomyela) & into za brainstem
    • (syringobulbia)
    • Aetiology:
    • It is due to rise of pressure within za closed
    • ventricular system consequent of blockage of
    • exit foramina of za 4 th ventricle 2nry to:
    • - Arnold Chiari malformation ( congenital
    • herniation of cerebellar tonsils through the
    • foramen magnum)
    • - Basal arachnoiditis
    • - Spinal cord trauma
    • NB : hydrocephalus may be asociated wz syringomyelia
  • 3.
    • Pathology:
    • Syrinx gradually destroys:
    • 1- decussating S/T tracts
    • 2- ant. horn cells
    • 3- lateral C/S tracts
    • 4- sympathetic tracts
    • 5- trigeminal, 1X, X, X1 & X11 cranial N nuclei
    • and vestibular system as syrinx extends to
    • the medulla.
  • 4.
    • Clinical features :
    • - insidious onset at za 3 rd or 4 th decade with
    • slow progression.
    • - cervical & shoulder pain
    • - dissociated sensory loss I za chest & ULs.
    • ( Cape distribution)
    • - painless burns & ulcers in za hands ( trophic)
    • - Charcot joints In za ULs.
    • - wasting of small muscles of za hands & loss
    • of one or more reflexes in za Uls.
    • - spastic paraparesis as disease progresses
    • - Horners, ataxia, bulbar palsy & loss of pain & temp in za face.
  • 5.
    • - kypho scoilosis, pes cavus & spina bifida are
    • common associations.
    • Investigations:
    • -plain X ray to show anomalies around F magnu
    • - MRI
    • Management
    • - Surgical decompression of za F magnum or
    • syrinx may arrest za progression & neurological
    • deficit, but No curative TR.
    • - Supportive measures.
    • Course : - disease gradually progressive over several decades & sudden deter may occur spontaneously or following trauma.

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