Multimedia
 | Media file 1: T1-weighted sagittal MRI scan demonstrates syringomyelia with a Chiari I malformation without hydrocephalus. The syrinx cavity does not communicate with the fourth ventricle and arises immediately caudal to the descended cerebellar tonsils. (See also next Image.) |
 | Media file 2: Corresponding T2-weighted cervical MRI scan of a patient with a Chiari I malformation (same patient as in Image above). Note the areas of flow void within the syrinx cavity. The flow void in the syrinx cavity is not a distinguishing characteristic of syringomyelia and may be seen in cases associated with Chiari malformations, posttraumatic syringes, and adhesive arachnoiditis. The presence of a cerebrospinal fluid flow void reflects the pulsatile movements of syrinx fluid. Such movements have been proposed as a cause of syrinx propagation, and observation of flow void may have prognostic significance. |
 | Media file 3: Midsagittal T1-weighted cervical MRI scan of a young man with a posttraumatic syrinx. Note how the syrinx extends rostrally from the level of the injury. The incidence of significant syringomyelia above the spinal fracture site is approximately 3-5%. With longer survival in paraplegic and quadriplegic patients, the incidence of posttraumatic syringomyelia is likely to increase. (See also next Image.) |
 | Media file 4: Midsagittal T2-weighted cervical MRI scan (same patient as in Image above) demonstrates a flow void sign in the center of the posttraumatic syrinx, reflecting pulsatile fluid motion. Detection of cerebrospinal fluid (CSF) movement in a posttraumatic spinal cord lesion may alter therapy. Preoperative assessment may be made on the basis of the presence or absence of the flow void sign on T2-weighted MRI. Symptomatic posttraumatic syringes with positive flow void sign respond favorably to syrinx-subarachnoid shunting. |
 | Media file 5: Conus ependymoma associated with syringohydromyelia. Gadolinium-enhanced sagittal MRI scan of the thoracolumbar junction demonstrates an enhancing tumor in the conus medullaris. The syrinx extends rostrally into the cervical cord (not shown). MRI studies of syringomyelia should involve the entire cord to exclude associated pathologies and should include intravenous contrast—enhanced MRI studies to exclude tumor. |
 | Media file 6: Postoperative arachnoiditis with secondary syringomyelia. T1-weighted sagittal MRI scan shows L1 vertebral body wedge fracture, extensive laminectomy, and a large loculated syrinx. Deformity of the cord margins may suggest arachnoiditis. Adhesive spinal arachnoiditis may develop after trauma, infection, subarachnoid hemorrhage, and spinal surgery. |
More on Syringohydromyelia |
| Overview: Syringohydromyelia |
| Imaging: Syringohydromyelia |
 Multimedia: Syringohydromyelia |
| References |
| Further Reading |
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References
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Further Reading
Related eMedicine topics:
Syringomyelia
Posttraumatic Syringomyelia
Chiari I Malformation
Chiari II Malformation
Keywords
syringohydromyelia, hydromyelia, syringomyelia, hydrocephalus, multiple sclerosis, spinal arachnoiditis, cord syrinx, tubular cavitation of spinal cord
