Acute syringomyelia: case report.
OBJECTIVE
Syringomyelia is generally regarded as a chronic, slowly progressive disorder. We describe a case of acute dilation of the central canal of the spinal cord that presented with rapidly progressive segmental signs.


METHODS
A 29-year-old female patient who had previously undergone surgical treatment for a Chiari I malformation, syringomyelia, and hydrocephalus presented with an 8-day history of headaches, progressive paraparesis, and urinary retention. Magnetic resonance imaging scans demonstrated panventricular hydrocephalus in association with a holocord syrinx that extended to the obex. Magnetic resonance imaging scans that had been coincidentally obtained just 3 days before the onset of symptoms had revealed no evidence of hydrocephalus or syringomyelia.


METHODS
The patient underwent emergency revision of a failed ventriculoperitoneal shunt. Postoperatively, there was prompt resolution of the syringomyelia, hydrocephalus, and associated neurological deficits.


CONCLUSIONS
Among patients with communicating syringomyelia, the central canal of the spinal cord participates as a "fifth ventricle" and can undergo rapid dilation in association with acute hydrocephalus. Appropriate treatment in such cases involves placement of a ventriculoperitoneal shunt.
Department of Neurosurgery, The Chiari Institute, North Shore-Long Island Jewish Health System, Manhasset, New York 11030, USA. Milhorat@nshs.edu
Thomas H
TH
Milhorat
Paolo A
PA
Bolognese
Karen S
KS
Black
Rona F
RF
Woldenberg
D000208:Acute Disease; D000328:Adult; D004868:Equipment Failure; D005260:Female; D006801:Humans; D013595:Syringomyelia / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013997:Time Factors; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*