Syringomyelia

Excerpt

Syringomyelia, at its core, is a disorder characterized by abnormal cerebrospinal fluid (CSF) circulation, leading to the formation of fluid-filled cavities (syrinx) within the spinal cord parenchyma or central canal. A syrinx is a fluid-filled cavity anatomically within the spinal cord parenchyma or the central canal. This condition is often associated with Chiari malformation type 1 (CM-1) but can also result from various factors such as spinal cord tumors, trauma, or infectious adhesive arachnoiditis.

Although syringomyelia predominantly presents with sensory symptoms such as pain and temperature insensitivity, it is an incidental finding in most cases. The discovery of syringomyelia is more common because of the increased use of magnetic resonance imaging (MRI) in the routine evaluation of back and neck pain.

The natural history of patients with syringomyelia is variable and unpredictable, with periods of stability and progression. Although professionals do not completely understand the natural history of syringomyelia, the clinical course typically progresses over months to years, with an early rapid deterioration that gradually slows down. Sudden head jolting or prolonged bouts of coughing can trigger a sudden onset of symptoms in a previously asymptomatic patient, presumably because of an increase in tonsillar descent. Notably, syringomyelia accounts for up to 5% of paraplegia.