Syringomyelie

T2-weighted

MR image of a syrinx located at C6-C7 in the cervical spine. Uploaded by me (Linsey E.) to Wikipedia and released into public domain. -- Cyborg Ninja 06:46, 19 February 2007 (UTC)

Wikipedia • Public domain

Ultrasound of

13 d old male infant with lumbar syringo/hydromyelia

Wikipedia • CC BY-SA 4.0

Syringohydromyelie

und Diastematomyelie unmittelbar daran angrenzend. Kein Nachweis eines sagittalen, duralen Strangs, der das Myelon teilt. Bildgebend war nicht zwischen einer Syringomyelie (Flüssigkeit um den Zentralkanal) und einer Hydromyelie (Erweiterung des Zentralkanals) zu unterscheiden, weshalb der Begriff Syringohydromyelie zusammenfassend gewählt wird.

Wikipedia • CC BY-SA 4.0

Novel cAMP

binding protein-BP (CREBBP) mutation in a girl with Rubinstein-Taybi syndrome, GH deficiency, Arnold Chiari malformation and pituitary hypoplasia. In this image, two syringomyelic cavity are evident, one of these is to cervical level, C5-T2 (thick arrow), and the other one to dorsal level, T5-T9 (thin arrow).

bmcmedgenet.biomedcentral.com • CC-by-2.0

Syringomyelia

• Syringomyelia - Ganzer Fall bei Radiopaedia

Daire, A. Syringomyelia. Case study, Radiopaedia.org. (accessed on 07 Nov 2022) https://doi.org/10.53347/rID-31265 • CC by-nc-sa 3.0 (modified)

Syrinx •

Chiari 1 malformation with syrinx - Ganzer Fall bei Radiopaedia

Gaillard, F. Chiari 1 malformation with syrinx. Case study, Radiopaedia.org. (accessed on 21 Oct 2022) https://doi.org/10.53347/rID-4977 • CC by-nc-sa 3.0 (modified)

Syrinx •

Syringomyelia - Ganzer Fall bei Radiopaedia

Schubert, R. Syringomyelia. Case study, Radiopaedia.org. (accessed on 21 Oct 2022) https://doi.org/10.53347/rID-14108 • CC by-nc-sa 3.0 (modified)

Radiopaedia • CC-by-nc-sa 3.0 • de

Syringomyelia refers to a cystic collection, or syrinx, that occurs within the spinal cord around the central canal.

Terminology

Although syringomyelia is distinct from hydromyelia, in which there is simply dilatation of the central canal, it is very difficult to distinguish the two on imaging. Hence, the collective terms hydrosyringomyelia or syringohydromyelia can also be used to describe this fluid collection within the cord.

Clinical presentation

Patients with this condition demonstrate a wide variety of neurological symptoms depending on where exactly the syrinx is located, but classically patients present with:

a cape-like loss of pain and temperature sensation along the back and arms, known as a ‘suspended sensory level’
disproportionately greater bilateral motor impairment in upper compared to lower extremities

This motor and sensory impairment can eventually cause atrophy, which begins in the hands and progresses proximally, resulting in deformities such as 'claw hands' and Charcot’s arthropathy .

Pathology

Syringomyelia applies to any cavity within the substance of the spinal cord that may or may not communicate with the central canal (ependyma does not line the cavity wall). In syringomyelia, there is a dissection of the ependymal lining of the central canal and CSF collection within the cord itself. Therefore, the collection does not have an ependymal lining.

Characteristically, the syrinx is in the cervicothoracic cord, with C2 to T9 being the most common location, however, the lesion may descend all the way down to the conus medullaris. There are numerous causes and associations, and these are discussed in more depth in the general article on syrinx.

Radiographic features

Syringomyelia has the same radiographic characteristics on all imaging modalities as any other syrinx. See syrinx for an in-depth discussion of these characteristics.