Today I want to tell you about an injury that is sometimes found between the results of an MRI and that may be very important. Having a syringomyelia can have serious consequences causing a spinal cord injury or be a simple finding without disease.
E211B the spinal cord is the structure that is continued with the brain and that distributes almost all the nerves by the body. It is lodged and descends inside the column. If you look at the photo, cutting the marrow in half we can see that in the center there is a small hole. Well, this little hole is a small canal through which cerebrospinal fluid (the fluid in the brain’s cavities) flows and is connected to the brain’s cavities.
Syringomyelia is the formation of cysts of cerebrospinal fluid. They can be glued to this central hole or separated from it inside the medulla. In short, it is a cavity filled with fluid that forms inside the spinal cord. Most of these lesions are formed in the context of a Chiari type I malformation (see post) although there are other causes. Other malformations such as alterations in the development of the neural tube, infections, spinal tumors or even trauma can cause them.
E211C If you look at the initial photo of the post you can see the marrow with a small whitish cavity in the image. This area should be dark gray like the rest. It looks white in this MRI socket because of its liquid content.
Why is syringomyelia formed? The mechanism has been studied mainly in patients with Chiari type I malformation. The cysts that are formed are thought to be due to the increase in pressure caused by the blockage in the normal flow of cerebrospinal fluid in the foramen magnum Skull by which the marrow comes out). This increase of pressure in the venous system causes an excess of fluid that accumulates in the marrow and is being reabsorbed and drained to this central channel of which we were talking. Sometimes this canal will dilate and these syringomyelia cavities are formed.
What can happen to me if I have syringomyelia?
These cavities that are formed can be asymptomatic, that is, they do not give any problem or symptom to the patient. In these cases is discovered by chance when performing an MRI. The problem is in cases where symptoms appear and are progressively increasing.
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The symptoms that we are going to have with syringomyelia are neurological and given the complexity of the marrow and depending on the location affected can be very varied. Let’s list some of the symptoms that we can note:
– In very frequent begin with alteration in the march due to the position that the cyst usually has in the marrow. We noticed that we did not walk well, that we are awkward, that the legs do not respond to us the same. Spasticity may occur in the legs (we notice them more rigid and difficult to move them).
– Irradiated pain as if it were a root entrapment by a hernia.
– Sensitivity changes, feeling pain when touching us, for example or not noticing the temperature of the shower.
– We may notice lack of mobility in some muscle groups of the arms and feel that they do not respond to us.
– In some cases, syringomyelia may occur above the medulla, in the area of the brain stem called the medulla oblongata. This condition is called syringobulbia and symptoms affect other functions such as breathing, heart rate, swallowing or phonation.
If the neurological problem progresses it may be necessary the surgical intervention that will be carried out by a Neurosurgeon. In an intervention of this type, the cavity is communicated with the rest of the cerebrospinal fluid and decompression of the affected area. If there is a cause such as a tumor, try to act on it to eliminate the cause.
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In short, syringomyelia can have serious consequences and the only way to stop it is with surgery when the symptoms begin. If we detect a cavity of syringomyelia without other factors and we have no symptoms, the normal thing is that it continues like this and we do not have problems. Even so we must know that we must go to the doctor soon to symptoms such as we have described. Equally important is in cases diagnosed Arnold Chiari type I where there is the risk of this complication. They should receive periodic follow-up to detect possible complications or even anticipate them depending on the patient’s symptoms. It should not be forgotten that after a trauma to the spine this complication can occur, even months after the initial injury.