Unilateral aplasia of the middle cranial fossa floor in atypical hemifacial microsomia.
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We present the first report of a patient with atypical hemifacial microsomia (HFM) and unilateral aplasia of the floor of the middle cranial fossa, glenoid fossa, and portions of her posterior fossa. The patient also developed a Chiari I malformation with cervical syrinx over a 3-year interval. This case report highlights the critical role of imaging in revealing serious, but clinically occult, structural abnormalities, as well as the evolution in the pathogenetic understanding of HFM. (+info)
The historical development of dural substitutes and the process of regeneration of dura mater are reviewed. Lyophilised human cadaver dura mater has been implanted intracranially in baboons and the graft shown to be incorporated with vascularisation but with ossification. In the human, lyophilised dura mater used as a dural substitute also becomes a viable tissue but without ossification. A retrospective study of its use in 100 neurosurgical patients showed a low complication rate and it is suggested that there are occasions when the ready availability of lyophilised dura mater, without the need for a further incision, makes it the dural substitute of choice. (+info)
Hydrocephalus and syringomyelia in a cat.
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A 3-month-old male Japanese cat with feline parvovirus infection, showing central and cervical nerve abnormalities, was diagnosed as hydrocephalus and syringomyelia by use of magnetic resonance imaging (MRI). The cat was maintained clinically by medical treatment even though he could not stand. The MRI scans obtained about 5 months later showed that the ventricles had increased in size and the cervical syrinx had extended into the thoracic spinal cord. Ventriculoperitoneal (VP) shunt was performed. One week after surgery, neurological conditions had improved. At the postoperative MR images, the ventricles had decreased in size and the syrinx in the cervical and thoracic spinal cord could no longer be seen. The cat was still alive and was able to walk well. (+info)
Evaluation of CSF motion in syringomyelia with spatial modulation of magnetization (SPAMM).
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CSF flow dynamics has been known to have a key role the pathogenesis of syringomyelia. Our purpose was to evaluate the CSF flow pattern in syringomyelia with spatial modulation of magnetization (SPAMM) that can depict directional flow, and to determine the relationship between flow dynamics and clinical outcome after decompress surgery. We performed pre- and post-operative MRI in 9 patients with syringomyelia with SPAMM technique. They showed caudal shift of tagging bands in the syrinx cavity in systolic phase while stagnation of CSF flow was seen in diastolic phase. The degree of band shift in syrinx was well correlated with the degree of shrinkage in size of syrinx after operation. Evaluation of syringomyelia by SPAMM technique can predict postsurgical outcome after decompress surgery. (+info)
Syringomyelia as a cause of limb hypertrophy.
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A case of limb hypertrophy secondary to syringomyelia is presented. (+info)
Intermittent positive airway pressure by nasal mask as a treatment for respiratory insufficiency in a patient with syringomyelia.
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We report a case of a 73-year-old woman with chronic respiratory failure in association with syringohydromyelia and sleep apnea. She was initially intubated and mechanically ventilated. Weaning from the ventilator was only successful after nasal intermittent positive airway pressure therapy was started. A normalization of arterial blood gas exchange could be achieved. (+info)
Spinal cord edema preceding syringomyelia associated with Chiari I malformation--case report.
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A 38-year-old woman with Chiari I malformation presented with spinal cord edema preceding syringomyelia manifesting as a 5-month history of nuchal pain and numbness of the upper extremities. Magnetic resonance imaging showed spinal cord edema, a poorly defined syrinx at the C-2 to T-2 levels, and distorted cerebellar tonsils. Computed tomography revealed cerebrospinal fluid (CSF) density in the center of spinal cord edema, and positron emission tomography revealed no uptake of L-[methyl-11C]methionine, indicating a non-neoplastic lesion. Craniocervical decompression achieved excellent clinical and neuroradiological outcomes. The success of surgical treatment supports the theory that patients with Chiari I malformation have increased transmural flow of CSF, causing spinal cord edema that progresses to syringomyelia. Early treatment of patients with spinal cord edema is indicated to prevent permanent spinal cord injury due to progressive syringomyelia. (+info)
Endoscopic fenestration of posterior fossa arachnoid cyst for the treatment of presyrinx myelopathy--case report.
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A 32-year-old man presented with an arachnoid cyst of the posterior fossa manifesting as cervical syringomyelic myelopathy. Magnetic resonance (MR) imaging demonstrated edematous enlargement and T2 prolongation of the cervical spinal cord, indicating a "presyrinx" state. MR imaging showed the inferior wall of the cyst, which disturbed cerebrospinal fluid (CSF) pulsatile movement between the intraspinal and intracranial subarachnoid spaces. The cyst wall was fenestrated with a neuroendoscope. The presyrinx state and the CSF movement improved. Posterior fossa arachnoid cyst, as well as Chiari malformation, can cause CSF flow disturbance at the craniocervical junction and syringomyelia. Endoscopic fenestration is less invasive than foramen magnum decompression and should be the procedure of choice. (+info)