Syringomyelia as a consequence of compressive extramedullary lesions: Postoperative clinical and radiological manifestations

M. Castillo, Robert Quencer, Barth A Green, B. M. Montalvo

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Abstract

MR imaging was performed to determine the cause of the onset of new neurologic symptoms in five patients who had previously undergone surgical excision of extramedullary masses. Syringomyelia and the absence of recurrent or residual lesions were documented in all cases. Three patients showed long cysts (multiseptated in two and smooth in one) with low signal intensity on both T1- and T2-weighted images. The flow-void phenomenon related to fluid motion in these three cysts, which were enlarging clinically, was responsible for the hypointensity on the T2-weighted images. In two patients the fluid within the lesions behaved similarly to normal nonpulsatile CSF and may have represented syrinx cavities in a state of 'arrested growth'. Three patients had surgical decompression under real-time intraoperative sonographic control, which showed the presence of intramedullary cyst-fluid pulsations in two cases and the absence of cyst-fluid pulsations in one case. These sonographic observations correlated with the MR findings. We postulate that these syrinx cavities form as a result both of the effect that the original extramedullary lesion had upon the underlying spinal cord and the subsequent postoperative alterations in the CSF dynamics at the level of prior surgery. Syringomyelia should be considered in patients with recurrent or new symptoms who previously had surgery for extramedullary lesions.

Original languageEnglish
Pages (from-to)391-396
Number of pages6
JournalAmerican Journal of Roentgenology
Volume150
Issue number2
StatePublished - Dec 1 1987

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Syringomyelia
Cyst Fluid
Syringes
Cysts
Surgical Decompression
Neurologic Manifestations
Spinal Cord
Growth

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Syringomyelia as a consequence of compressive extramedullary lesions : Postoperative clinical and radiological manifestations. / Castillo, M.; Quencer, Robert; Green, Barth A; Montalvo, B. M.

In: American Journal of Roentgenology, Vol. 150, No. 2, 01.12.1987, p. 391-396.

Research output: Contribution to journalArticle

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