• Journal of Korean Neurosurgical Society
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• v.45 no.5
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• pp.315-317
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• 2009

While syringomyelia is not a rare spinal disorder, syringomyelia associated with a spinal arachnoid cyst is very unusual. Here, we report a 62-year-old man who suffered from gait disturbance and numbness of bilateral lower extremities. Spinal magnetic resonance imaging (MRI) showed the presence of a spinal arachnoid cyst between the 7th cervical and 3rd thoracic vertebral segment and syringomyelia extending between the 6th cervical and 1st thoracic vertebral segment. The cyst had compressed the spinal cord anteriorly. Syringomyelia usually results from lesions that partially obstruct cerebrospinal fluid flow. Therefore, we concluded that the spinal arachnoid cyst was causing the syringomyelia. After simple excision of the arachnoid cyst, the symptoms were relieved. A follow-up MRI demonstrated that the syringomyelia had significantly decreased in size after removal of the arachnoid cyst. This report presents an unusual case of gait disturbance caused by syringomyelia associated with a spinal arachnoid cyst.

• Journal of Korean Neurosurgical Society
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• v.63 no.3
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• pp.338-341
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• 2020

Cases of syringomyelia associated with spinal dysraphism are distinct from those associated with hindbrain herniation or arachnoiditis in terms of the suspected pathogenetic mechanism. The symptoms of terminal syringomyelia are difficult to differentiate from the symptoms caused by spinal dysraphism. Nonetheless, syringomyelia has important clinical implications, as it is an important sign of cord tethering. The postoperative assessment of syringomyelia should be performed with caution.

• Journal of Korean Neurosurgical Society
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• v.57 no.4
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• pp.311-313
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• 2015

Chiari type I malformation is a tonsillar herniation more than 3 mm from the level of foramen magnum, with or without concurrent syringomyelia. Different surgical treatments have been developed for syringomyelia secondary to Chiari's malformations: craniovertebral decompression with or without plugging of the obex, syringo-subarachnoid, syringo-peritoneal, and theco-peritoneal shunt placement. Shunt placement procedures are useful for neurologically symptomatic large-sized syrinx. In this paper, authors define the first successful treatment of a patient with syringomyelia due to Chiari type I malformation using a pre-defined new technique of syringo-subarachnoid-peritoneal shunt with T-tube system.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.1
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• pp.246-251
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• 2008

Syringomyelia is a rare disorder that causes a cyst to form in spinal cord. This cyst, called a syrinx, can damage to the spinal cord and cause symptoms such as motor weakness, pain, sensory disturbance, etc. We experienced a case of tactile hypesthesia suspecting syringomyelia in 16 year old male patient. Syringomyelia in T2/3 level was diagnosed by magnetic resonance imaging. Hypesthesia was similar to mamokbulin in oriental medicine. And we assumed these symptoms induced by conditions called kiheo in analyzing patient's symptoms and signs. We treated the patient by acupuncture, herbal medicine improving kiheo, and other methods. In the result, the symptoms had withdrawn. This case suggested possibility to treat syringomyelia in oriental medicine, but single case is insufficient for evidence.

• Journal of Korean Neurosurgical Society
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• v.29 no.2
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• pp.274-279
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• 2000

A 35-year-old female patient who had been paraplegic since her upper thoracic cord injury one and a half years before was presented with a syringomyelia involving C7 to T2 cord segments on follow-up magnetic resonance imaging(MRI). Her pain on the chest and bilateral axilla worsened since about 2 years after initial injury, and MRI demonstrated a progressively enlarging cystic syrinx cavity of the cervicothoracic cord. The posttraumatic syringomyelia was managed operatively by lysis of the arachnoid adhesions, myelotomy, and expansile duraplasty. Post-operatively her pain was relieved, and MRI showed decrease in size of the syrinx, and digital infrared thermographic imaging(DITI) showed diminution of the hyperthermic area on the anterior chest. In conclusion, the posttraumatic syringomyelia can be managed successfully without shunt operation. It seems apparent that expansile duraplasty is effective in controlling the posttraumatic syrinx.

• Journal of Korean Neurosurgical Society
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• v.29 no.2
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• pp.255-260
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• 2000

The authors report a posttraumatic syringomyelia in a 30-year-old man who has complained pain, weakness of upper arm and dissociation sensory loss since 2 months before. He was underwent by decompressive laminectomy from T12 to L1, reduction of encroached bony fragments, transpedicular screw fixation from T12 to L2 and posterolateral bony fusion due to burst fracture of L1 at other hospital 3 years ago. Preoperative spinal MRI was highly suggestive of wide-spread, multiseptated syringomyelia from C3 to thoracolumbar junction. We performed wide decompressive laminectomy from T10 to L2 and subarachnoid space reconstrucion composed of microdissection of meningeal fibrosis widely, iatrogenic meningocele formation with lefting the dura mater opened for treatment of spinal-spinal pressure dissociation. Clinical manifestations and radiological findings of the patient were improved after the operation. This technique was thought to be superior to shunting procedures in cases of wide-spread, multiseptated post-traumatic syringomyelia.

• Journal of Korean Neurosurgical Society
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• v.47 no.3
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• pp.228-231
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• 2010

Posttraumatic syringomyelia may result from a variety of inherent conditions and traumatic events, or from some combination of these. Many hypotheses have arisen to explain this complex disorder, but no consensus has emerged. A 28-year-old man presented with progressive lower extremity weakness, spasticity, and decreased sensation below the T4 dermatome five years after an initial trauma. Magnetic resonance imaging (MRI) revealed a large, multi-septate syrinx cavity extending from C5 to L1, with a retropulsed bony fragment of L2. We performed an L2 corpectomy, L1-L3 interbody fusion using a mesh cage and screw fixation, and a wide decompression and release of the ventral portion of the spinal cord with an operating microscope. The patient showed complete resolution of his neurological symptoms, including the bilateral leg weakness and dysesthesia. Postoperative MRI confirmed the collapse of the syrinx and restoration of subarachnoid cerebrospinal fluid (CSF) flow. These findings indicate a good correlation between syrinx collapse and symptomatic improvement. This case showed that syringomyelia may develop through obstruction of the subarachnoid CSF space by a bony fracture and kyphotic deformity. Ventral decompression of the obstructed subarachnoid space, with restoration of spinal alignment, effectively treated the spinal canal encroachment and post-traumatic syringomyelia.

• Journal of Acupuncture Research
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• v.36 no.1
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• pp.45-49
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• 2019

The purpose of this study was to describe the treatment of the clinical symptoms of syringomyelia using Korean medicine. A patient with syringomyelia complained of back and shoulder pain, numbness of the upper right limb, headaches and dyspnea. He was treated with herbal medicine, acupuncture, moxibustion, and physical therapy. The Visual analog scale (VAS) was used to score sensory symptoms (pain, numbness) and Modified Borg scale (mBorg) was used to score dyspnea. After the treatment, his symptoms were relieved. The patient's chief complaint was back and shoulder pain which was reduced greatly from a VAS score of 6 between 1-2. The results in this study may contribute to the development of the Korean medicine field of syringomyelia in the future.

• The Korean Journal of Pain
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• v.21 no.3
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• pp.248-251
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• 2008

The clinical syndrome of posttraumatic syringomyelia can complicate major spinal trauma and develops many months after spinal injury. The 50-90% of patients experienced the pain and especially the component of central pain. In patients with central pain following spinal cord injury, ketamine has been shown to be an effective analgesic. We report a case of posttraumatic syringomyelia in a 30-year-old woman who complained of central pain, weakness of both legs and dysesthesia. She had not responded to pulsed radiofrequency, or lidocaine infusion therapy, but a continuous intravenous infusion of ketamine, an N-methyl-D-asparate receptor antagonist, reduced her severe central pain. In conclusion, a ketamine infusion therapy resulted in a significant reduction of central pain without decreasing of motor power and function.

• Journal of Korean Neurosurgical Society
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• v.29 no.10
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• pp.1389-1395
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• 2000

A case report of a post-traumatic syringomyelia in a 29-year old male, developed 15 years after an L1 burst fracture, is presented. On preoperative MRI, the syrinx extended cephalad above the fracture site through the whole thoracic and cervical cord. Serial myelo-CT was performed to evaluate the dynamics of CSF. It was managed by lysis of the arachnoid adhesions, syringosubarachnoid shunt, and expansile duraplasty. After surgery, the patient's symptoms improved, and marked decrease of the syrinx was seen on postoperative MRI. The pathophysiology, the role of preoperative diagnostic methods especially serial myelo-CT, and the contmporary management modalities for posttraumatic syringomyelia is reviewed along with the pertinent literature.