Acute presentations of syringomyelia

Report of three cases

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✓ Three unusual cases are reported in which communicating syringomyelia presented acutely. The first patient presented with paraplegia, the second with acute respiratory distress secondary to bilateral vocal cord paralysis, and the third with symptoms of acute brain-stem ischemia. Each patient had a communicating spinal cord syrinx associated with a posterior fossa and foramen magnum region anomaly (a huge posterior fossa arachnoid cyst in one and Chiari malformations in two). The mechanisms of craniospinal pressure dissociation and hindbrain herniation are discussed, along with other reported emergency presentations of syringomyelia.

Article Information

Address reprint requests to: Eric L. Zager, M.D., Division of Neurosurgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, Pennsylvania 19104.

© AANS, except where prohibited by US copyright law.

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    Case 2. Midsagittal magnetic resonance image demonstrating the Chiari type I malformation (previously decompressed) and the syrinx cavity extending throughout the cervical cord and into the upper thoracic cord.

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