Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-29T04:05:23.308Z Has data issue: false hasContentIssue false
  • English
  • Français

Syrinx Extending from Conus Medullaris to Basal Ganglia: A Clinical, Radiological, and Pathological Correlation

Published online by Cambridge University Press:  18 September 2015

R. Del Bigio Marc ,
H.N. Deck John  and
J. Kerry MacDonald
R. Del Bigio Marc*
Affiliation:
Division of Neuropathology, Department of Pathology, University of Toronto, Toronto, Ontario
H.N. Deck John*
Affiliation:
Division of Neuropathology, Department of Pathology, University of Toronto, Toronto, Ontario
J. Kerry MacDonald*
Affiliation:
Division of Neuropathology, Department of Pathology, University of Toronto, Toronto, Ontario
*
Department of Pathology, The Toronto Hospital, 399 Bathurst Street, Toronto, Ontario, Canada M5T 2S8
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

A 41-year-old woman with a history of birth injury to the brachial plexus suffered several delayed episodes of neurological deterioration. Magnetic resonance imaging studies revealed a syrinx extending from the conus medullaris into the brainstem and rostrally into both internal capsules. She died of an acute exacerbation of chronic respiratory failure. Autopsy demonstrated syringomyelia and syringobulbia with cavity extension bilaterally along the corticospinal tracts into the internal capsules. Islands of glial tissue in the subarachnoid space around the medulla caused obstruction of the subarachnoid space at the foramen magnum. These were probably the result of birth injury to the cerebellum. A detailed clinico-pathological correlation is provided to explain her neurological deficits. The pathogenesis of syrinx formation is discussed in terms of a late manifestation of birth trauma.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 20 , Issue 3 , August 1993 , pp. 240 - 246
Copyright
Copyright © Canadian Neurological Sciences Federation 1993

References

REFERENCES

1.Jonesco-Sisesti, N, translated by Ross, RT. Syringobulbia. A Contribution to the Pathophysiology of the Brainstem. New York: Praeger, 1986 (original 1932).Google Scholar
2.Samples, JR, Howard, FM, Okazaki, H. Syringomesencephalia. Report of a case. Arch Neurol 1983; 40: 757–759.Google Scholar
3.Hardy, RC, Stevenson, LD. Syringomesencephalia. Report of a case with signs of Parkinson's disease having a syrinx in the substantia nigra. J Neuropathol Exp Neurol 1957; 16: 365–370.CrossRefGoogle ScholarPubMed
4.Berry, RG, Chambers, RA, Lublin, FD. Syringoencephalomyelia (syringocephalus). J Neuropathol Exp Neurol 1981; 40: 633–644.CrossRefGoogle ScholarPubMed
5.Foster, JB, Hudgson, P. The pathology of communicating syringomyelia. In: Barnett, HJM, Foster, JB, Hudgson, P, ed. Syringomyelia. London: W.B. Saunders 1973; 79–103.Google Scholar
6.Lombardo-Rivera, L, Saenz-Arroyo, L. Siringomielia y siringobulbia. Rev Med Hosp Gen (Mex) 1961; 24: 363–370.Google Scholar
7.Spiller, WG. Syringomyelia extending from the sacral region of the spinal cord through the medulla oblongata, right side of the pons and right cerebral peduncle to the upper part of the right internal capsule (syringobulbia). Brit Med 1906; 2: 1017–1021.Google Scholar
8.Okada, S, Nakagawa, Y, Hirakawa, K. Syringomyelia extending to the basal ganglia: case report. J Neurosurg 1989; 71: 616–617.CrossRefGoogle Scholar
9.Rhoton, EL, Rhoton, AL. Chiari malformation with syringocephaly. Case report. J Neurosurg 1991; 75: 791–794.Google ScholarPubMed
10.Valentini, MC, Forni, C, Bracchi, M. Syringobulbia extending to the basal ganglia. Am J Neuroradipl 1988; 9: 205–207.Google ScholarPubMed
11.Tork, I, McRitchie, DA, Rikard-Bell, GC, Paxinos, G.Autonomic regulatory centers in the medulla oblogatta. In: Paximos, G, ed. The Human Nervous System. San Diego: Academic Press 1990: 221–259.CrossRefGoogle Scholar
12.Nieuwenhuys, R, Voogd, J, van, Huijzen C. (translated) The Human Central Nervous System. A Synopsi and Atlas. Berlin: Springer Verlag 1988.Google Scholar
13.Painer, MJ, Bergman, I. Obstetrical trauma to the neonatal central and peripheral nervous system. Seminars Perinatol 1982; 6: 89–104.Google Scholar
14.Barnett, HJM. The Epilogue. In: Barnett, HJM, Foster, JB. Hudgson, P, ed. Syringomyelia. London: W.B. Saunders Co. 1973: 302–313.Google Scholar
15.Rodman, T, Resnik, ME, Berkowitz, RD, Fennelly, JF, Olivia, J. Alveolar hypoventilation due to involvement of the respiratory center by obscure disease of the central nervous system. Am J Med 1962; 32: 208–217.CrossRefGoogle ScholarPubMed
16.Breen, LA. Gaze abnormalities. In: Walsh, TJ, ed. Neuro-ophthalmology: Clinical Signs and Symptoms. Philadelphia: Lea and Febiger 1992: 525–543.Google Scholar
17.Sharpe, JA, Rosenberg, MA, Hoyt, WF, Daroff, RB. Paralytic pontine exotropia. A sign of acute unilateral pontine gaze palsy and internuclear ophthalmoplegia. Neurology 1974; 24: 1076–1081.CrossRefGoogle ScholarPubMed
18.Abroms, IF, Bresnan, MJ, Zuckerman, JE, Fischer, EG, Strand, R. Cervical cord injuries secondary to hyperextension of the head in breech presentations. Obstet Gynecol 1973; 41: 369–378.Google ScholarPubMed
19.Jellinger, K, Schwingshackl, A. Birth injury of the spinal cord. Report of two necropsy cases with several weeks survival. Neuropaediatrie 1973; 4: 111–123.CrossRefGoogle ScholarPubMed
20.Leventhal, HR. Birth injuries of the spinal cord. J Pediatr 1960; 56: 447–453.CrossRefGoogle ScholarPubMed
21.Reid, H. Birth injury to the cervical spine and spinal cord. Acta Neurochir 1983; (Suppl) 32: 87–90.Google Scholar
22.Towbin, A. Spinal cord and brain stem injury at birth. Arch Pathol 1964; 77: 620–632.Google ScholarPubMed
23.Towbin, A. Latent spinal cord and brain stem injury in newborn infants. Dev Med Child Neurol 1969; 11: 54–68.CrossRefGoogle ScholarPubMed
24.Babyn, PS, Chuang, SH, Daneman, A, Davidson GS. Sonographic evaluation of spinal cord birth trauma with pathologic correlation. Am J Roetgenol 1988; 151: 763–766.CrossRefGoogle ScholarPubMed
25.Milhorat, TH, Adler, DE, Heger, IM. Miller, JI, Hollenberg-Sher, JR. Histopathology of experimental hematomyelia. J Neurosurg 1991; 75: 911–915.CrossRefGoogle ScholarPubMed
26.Barnett, HJM. Syringomyelia consequent on minor to moderate trauma. In: Barnett, HJM, Foster, JB, Hudgson, P, ed. Syringomyelia. London: W.B. Saunders 1973: 174–178.Google Scholar
27.Byers, RK. Spinal-cord injuries during birth. Dev Med Child Neurol 1975; 17: 103–110.CrossRefGoogle ScholarPubMed
28.Barnett, HJ, Boterell, EH, Jousse, AT, Wynn-Jones, M. Progressive myelopathy as a sequel to traumatic paraplegia. Brain 1966; 89: 159–174.CrossRefGoogle ScholarPubMed
29.Umbach, I. Post-spinal cord injury syringomyelia. Paraplegia 1991; 29: 219–221.Google ScholarPubMed
30.Williams, B. Pathogenesis of syringomyelia. In: Batzdorf, U, ed. Syringomyelia: Current Concepts in Diagnosis and Treatment. Baltimore: William and Wilkins 1991: 59–90.Google Scholar
31.Enzmann, DR, O'Donahue, J, Rubin, JB, et al.CSF pulsations within nonneoplastic spinal cord cysts. Am J Roetgenol 1987; 149: 149–157.CrossRefGoogle ScholarPubMed
32.Aubin, ML, Baleriaux, D, Cosnard, G, et al.MRI in syringomyelia of congenital, infectious, traumatic, or idiopathic origin. A study of 142 cases. J Neuroradiol 1988; 14: 313–336.Google Scholar
33.Aboulker, J. La syringomyelie et les liquides intra-rachidiens. Neurochirurgie 1979; 25: 55–64.Google Scholar
34.Hinokuma, K, Ohama, E, Oyanagi, K, et al.Syringomyelia. A neuropathological study of 18 autopsy cases. Acta Pathol Jpn 1992; 42: 25–34.Google ScholarPubMed
35.Vinters, HV. Neuropathology of syringomyelia. In: Batzdorf, U, ed. Syringomyelia: Current Concepts in Diagnosis and Treatment. Baltimore: Williamsand Wilkins 1991: 35–58.Google Scholar