Syrinx (medicine)

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A syrinx is a sparse neuroglial cavity, filled with fluid in the spinal cord (syringomyelia), in the brainstem (syringobulbia), or in the elbow nerve, usually at a young age.

Video Syrinx (medicine)

Presentations

Symptoms usually begin secretly between adolescence and age 45. Syringomyelia develops in the central spinal cord, causing central nervous syndrome. Sensory pain and temperature deficits occur early but may not be recognized for years. The first known abnormalities are burns or non-painful wounds. Syringomyelia usually causes weakness, atrophy, and often fasciculation and hiporefleksia in the hands and arms; deficits in pain and temperature sensation in capelike distribution over shoulder, arm and back are characteristics. Light touch and position and vibration sensation are not affected. Then, spastic foot weakness develops. The deficit may be asymmetric.

Syringobulbia can cause vertigo, nystagmus, loss of unilateral or bilateral facial sensations, lingual and weakness, dysarthria, dysphagia, hoarseness, and sometimes peripheral sensory or motor deficits due to medullary compression.

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Cause

The syrinx results when an aqueous protective substance known as cerebrospinal fluid, which normally flows around the spinal cord and brain, transports nutrients and waste products, collects in a small area of ​​the spinal cord and forms a pseudocyst.

A number of medical conditions can cause obstruction in the normal flow of cerebrospinal fluid, directing it to the spinal cord itself. For reasons that are now becoming clearer, this results in a syrinx formation. Cerebrospinal fluid fills syrinx. The pressure difference along the spine causes the fluid to move inside the cyst. Doctors believe that this is a continuous movement of fluid that produces cyst growth and further damage to the spinal cord.

In the case of syringomyelia, syrinx can expand and extend over time, destroying the spinal cord. Because the spinal cord connects the brain to the nerves in the extremities, this damage can result in pain, weakness, and stiffness in the back, shoulders, arms, or legs. Other symptoms may include headache and loss of ability to feel extremes of heat or cold, especially in the hand. Each patient experiences a combination of different symptoms. These symptoms usually vary depending on the level and, often more critically, to the location of the syrinx in the spinal cord.

Syrinxes are usually the result of lesions partially blocking the flow of CSF. At least ½ syrinxes occur in patients with congenital abnormalities of craniocervical confinement (eg herniation of the cerebellum tissue to the spinal canal, called Chiari malformation), brain (eg encephalocele), or spinal cord (eg Myelomeningocele - see Congenital Neurological Anomalies: Anomalies Brain). For unknown reasons, these congenital abnormalities often develop during adolescence or young adulthood. Syrinx may also develop in patients who have spinal cord tumors, scarring due to previous spinal trauma, or no known predisposing factors. About 30% of people with spinal cord tumors eventually develop syrinx.

Syringomyelia are paramedian, usually irregular, longitudinal cavities. Most commonly affect the cervical and thoracic regions but may extend further down or to the brainstem (syringobulbia). Syringobulbia, which is rare, usually occurs as a crevice-like slit in the lower stem of the brain and may interfere with or suppress the lower cranial nerves or sensory or descending motor pathways.

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Diagnosis

Syrinx is suggested by unexplained cord central syndrome or other characteristic neurological deficits, particularly pain and temperature sensory deficits in capelike distribution. MRI of the entire spinal cord and brain is performed. Intravenous Gadolinium administration during MRI examination is useful for detecting related tumors.

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Treatment

The underlying problems (eg craniocervical connection abnormalities, postoperative scarring, spinal tumors) are corrected whenever possible. The decompression surgery of the foramen magnum and upper cervical cord is the only useful treatment, but surgery usually can not reverse the severe neurological damage.

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Etymology

Syrinx is taken directly from the ancient Greek word for "tube." This is the root word "syringe."

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References

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External links

• http://www.merck.com/mmpe/sec16/ch224/ch224j.html?qt=syrinx&alt=sh

Source of the article : Wikipedia