The resolution of syringohydromyelia without hindbrain herniation after posterior fossa decompression

Bermans J. Iskandar Division of Pediatric Neurosurgery and Department of Pediatric Imaging, Children's Hospital, Birmingham, Alabama

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 M.D.
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Gary L. Hedlund Division of Pediatric Neurosurgery and Department of Pediatric Imaging, Children's Hospital, Birmingham, Alabama

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Paul A. Grabb Division of Pediatric Neurosurgery and Department of Pediatric Imaging, Children's Hospital, Birmingham, Alabama

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W. Jerry Oakes Division of Pediatric Neurosurgery and Department of Pediatric Imaging, Children's Hospital, Birmingham, Alabama

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Page Range:
212–216
Volume/Issue:
Volume 89: Issue 2
DOI link:
https://doi.org/10.3171/jns.1998.89.2.0212
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Object. To provide more information about this rare condition, the authors describe five cases of syringohydromyelia without hindbrain herniation. Preoperative magnetic resonance imaging with and without gadolinium—diethylenetriamine pentaacetic acid revealed no evidence of spinal cord tumor, arachnoiditis, or spinal dysraphism.

Methods. Craniocervical decompression was performed in all patients, after which there was resolution of the symptoms in the four symptomatic patients, and all five showed marked reduction in the size of the syrinx.

Conclusions. The authors hypothesize the rare occurrence of syringohydromyelia resulting from a Chiari-like pathophysiological condition but lacking a hindbrain hernia. Patients with this condition may benefit from craniocervical decompression.

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Contributor Notes

Address reprint requests to: Bermans J. Iskandar, M.D., Department of Neurological Surgery, University of Wisconsin Hospital and Clinics, 600 Highland Avenue, H4/334, Madison, Wisconsin 53792. email: iskandar@neuro-novell.neurosurg.wisc.edu.
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