Significance of positive Queckenstedt test in patients with syringomyelia associated with Arnold-Chiari malformations

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  • 1 Department of Neurosurgery, Kitasato University, School of Medicine, Kitasato, Japan
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✓ Ten patients with syringomyelia associated with Arnold-Chiari Type I malformations were evaluated. In each patient, a manometric Queckenstedt test was performed with the neck in various positions. No patient showed evidence of a block to the flow of cerebrospinal fluid (CSF) with the neck in the extended position; however, all showed a complete CSF block with the neck in a flexed position. Posterior fossa decompression with a C1–2 laminectomy was performed in nine cases, after which Queckenstedt test demonstrated free CSF communication in all nine with the neck in extension, in a neutral position, and in flexion. Postoperative magnetic resonance imaging showed shrinkage of the syrinx in the patients who underwent surgery. It is suggested that obstruction of the CSF pathway at the foramen magnum produced by neck movement is of importance in the formation and progression of a syrinx.

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  • 1.

    Adams CBT, & Logue V: Studies in cervical spondylotic myelopathy. I. Movement of the cervical roots, dura and cord, and their relation to the course of the extrathecal roots. Brain 94:557568, 1971 Adams CBT, Logue V: Studies in cervical spondylotic myelopathy. I. Movement of the cervical roots, dura and cord, and their relation to the course of the extrathecal roots. Brain 94:557–568, 1971

    • Search Google Scholar
    • Export Citation
  • 2.

    Ballantine HT Jr, , Ojemann RG, & Drew JH: Syringomyelia. Prog Neurol Surg 4:227245, 1971 Ballantine HT Jr, Ojemann RG, Drew JH: Syringomyelia. Prog Neurol Surg 4:227–245, 1971

    • Search Google Scholar
    • Export Citation
  • 3.

    Breig A: Adverse Mechanical Tension in the Central Nervous System. An Analysis of Cause and Effect Relief by Functional Neurosurgery. Stockholm: Almqvist & Wiksell International, 1978, p 125 Breig A: Adverse Mechanical Tension in the Central Nervous System. An Analysis of Cause and Effect Relief by Functional Neurosurgery. Stockholm: Almqvist & Wiksell International, 1978, p 125

    • Search Google Scholar
    • Export Citation
  • 4.

    Conway LW: Hydrodynamic studies of syringomyelia. J Neurosurg 27:501514, 1967 Conway LW: Hydrodynamic studies of syringomyelia. J Neurosurg 27:501–514, 1967

    • Search Google Scholar
    • Export Citation
  • 5.

    du Boulay G, , Shah SH, & Currie JC, et al: The mechanism of hydromyelia in Chiari type I malformations. Br J Radiol 47:579587, 1974 du Boulay G, Shah SH, Currie JC, et al: The mechanism of hydromyelia in Chiari type I malformations. Br J Radiol 47:579–587, 1974

    • Search Google Scholar
    • Export Citation
  • 6.

    Ellertsson AB, & Greitz T: The distending force in the production of communicating syringomyelia. Lancet 1:1234, 1970 (Letter) Ellertsson AB, Greitz T: The distending force in the production of communicating syringomyelia. Lancet 1:1234, 1970 (Letter)

    • Search Google Scholar
    • Export Citation
  • 7.

    Gardner WJ: Hydrodynamic mechanism of syringomyelia: its relationship to myelocele. J Neurol Neurosurg Psychiatry 28:247259, 1965 Gardner WJ: Hydrodynamic mechanism of syringomyelia: its relationship to myelocele. J Neurol Neurosurg Psychiatry 28:247–259, 1965

    • Search Google Scholar
    • Export Citation
  • 8.

    Gardner WJ, & Goodall RJ: The surgical treatment of Arnold-Chiari malformation in adults. J Neurosurg 7:199206, 1950 Gardner WJ, Goodall RJ: The surgical treatment of Arnold-Chiari malformation in adults. J Neurosurg 7:199–206, 1950

    • Search Google Scholar
    • Export Citation
  • 9.

    Grant WT, & Cone WV: Graduated jugular compression in the lumbar manometric test for spinal subarachnoid block. Arch Neurol Psychiatry 32:11941201, 1934 Grant WT, Cone WV: Graduated jugular compression in the lumbar manometric test for spinal subarachnoid block. Arch Neurol Psychiatry 32:1194–1201, 1934

    • Search Google Scholar
    • Export Citation
  • 10.

    Kaplan L, & Kennedy F: The effect of head posture on the manometrics of the cerebrospinal fluid in cervical lesions: a new diagnostic test. Brain 73:337345, 1950 Kaplan L, Kennedy F: The effect of head posture on the manometrics of the cerebrospinal fluid in cervical lesions: a new diagnostic test. Brain 73:337–345, 1950

    • Search Google Scholar
    • Export Citation
  • 11.

    Penning L: Functional Pathology of the Cervical Spine. Amsterdam: Excerpta Medica, 1968, p 105 Penning L: Functional Pathology of the Cervical Spine. Amsterdam: Excerpta Medica, 1968, p 105

    • Search Google Scholar
    • Export Citation
  • 12.

    Williams B: A critical reappraisal of posterior fossa surgery for communicating syringomyelia. Brain 101:223250, 1978 Williams B: A critical reappraisal of posterior fossa surgery for communicating syringomyelia. Brain 101:223–250, 1978

    • Search Google Scholar
    • Export Citation
  • 13.

    Williams B: The distending force in the production of “communicating syringomyelia.” Lancet 2:189193, 1969 Williams B: The distending force in the production of “communicating syringomyelia.” Lancet 2:189–193, 1969

    • Search Google Scholar
    • Export Citation
  • 14.

    Williams B: On the pathogenesis of syringomyelia: a review. J R Soc Med 73:798806, 1980 Williams B: On the pathogenesis of syringomyelia: a review. J R Soc Med 73:798–806, 1980

    • Search Google Scholar
    • Export Citation
  • 15.

    Williams B: Simultaneous cerebral and spinal fluid pressure recordings. 2. Cerebrospinal dissociation with lesions at the foramen magnum. Acta Neurochir 59:123142, 1981 Williams B: Simultaneous cerebral and spinal fluid pressure recordings. 2. Cerebrospinal dissociation with lesions at the foramen magnum. Acta Neurochir 59:123–142, 1981

    • Search Google Scholar
    • Export Citation

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