Materiały źródłowe

• #1 Syringomyelia: diagnosis and management | Practical Neurology

  https://pn.bmj.com/content/21/5/403

  In the pre-MR era syringomyelia often presented late, as a crippling neurological disorder. Today, most cases are diagnosed earlier, with less pronounced deficits. […] The classical presentation of syringomyelia, with combined upper and lower motor neurone features and autonomic disturbances, is now seen only occasionally. High expectations on the part of the public in terms of early diagnosis, together with ready availability of MR imaging, have led to many more syrinx cavities being detected, which are frequently not diagnosed clinically, before the scan. […] Syringomyelia may be defined as the presence of abnormal, CSF-filled cavities within the adult spinal cord. […] Syringomyelia can develop as a result of other anatomical abnormalities, besides Chiari malformations, and when a cavity is identified, we look to locate a point where normal, free movement of CSF is impeded.

• #1 Syringomyelia | National Institute of Neurological Disorders and Stroke

  https://www.ninds.nih.gov/health-information/disorders/syringomyelia

  A physician will review your medical history, perform a physical exam focusing on neurological function, and order imaging of the spine or brain. […] Magnetic resonance imaging (MRI) is the most reliable way to diagnose syringomyelia. Using this test, a physician can determine if a syrinx exists in the spine or if another abnormality exists, such as a tumor. […] NIH-funded researchers are working to improve diagnostic imaging techniques to better visualize spine conditions, including syringomyelia even before symptoms appear.

• #1 Diagnosing Syringomyelia – USA Spine Care – Laser Spine Surgery

  https://usaspinecare.com/spine/diagnosing-syringomyelia/

  Diagnosing syringomyelia can be challenging as the symptoms often mimic other conditions. A combination of medical history, physical examination, and imaging tests is typically required for accurate diagnosis. […] A detailed medical history is essential. Healthcare providers will inquire about the onset and progression of symptoms, including pain, weakness, numbness, and balance issues. Information about any previous injuries, surgeries, or family history of spinal conditions is also valuable. […] A thorough physical examination involves assessing reflexes, muscle strength, sensation, and coordination. Doctors may perform specific tests to evaluate spinal cord function. […] Imaging studies are crucial for diagnosing syringomyelia. The most common tests include: […] MRI provides detailed images of the spinal cord and surrounding tissues, allowing for clear visualization of the syrinx. […] Early diagnosis is crucial for effective management of syringomyelia. If you experience symptoms suggestive of this condition, its important to consult with a healthcare professional for proper evaluation.

• #1 Syringomyelia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/syringomyelia/diagnosis-treatment/drc-20354775

  Your healthcare professional asks about your medical history and do a complete physical exam. In some cases, syringomyelia might be discovered during a spine MRI or CT scan conducted for other reasons. […] If your healthcare professional suspects you may have syringomyelia, you may need to undergo testing. Tests may include: […] An MRI scan of the spine and spinal cord is the most reliable tool for diagnosing syringomyelia. […] An MRI uses radio waves and a strong magnetic field to produce detailed images of the spine and spinal cord. If a syrinx has developed within the spinal cord, it is visible on the MRI scan. […] The MRI might be repeated over time to monitor the progression of syringomyelia. […] A CT scan uses a series of X-rays to create a detailed view of the spine and spinal cord. It can reveal tumors or other spine conditions.

• #1 Syringomyelia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537110/

  Assess the progression of syringomyelia using appropriate imaging techniques and clinical evaluations. […] Collaborate with other healthcare professionals to optimize patient outcomes and coordinate comprehensive care plans for individuals with syringomyelia. […] MRI, with and without contrast, is the preferred imaging modality. […] The scan allows for precise delineation of relevant anatomy and accurate visualization of the syrinx in both sagittal and axial planes. […] MRI quickly reveals crucial information such as the syrinx cavity’s location, size, and extent, along with assessing the degree of cerebellar tonsillar ectopia. […] Longitudinal MRI studies can also track syrinx progression over months or years, providing valuable insights into the natural history of syringomyelia.

• #1 Malformations of the craniocervical junction (chiari type I and syringomyelia: classification, diagnosis and treatment) | BMC Musculoskeletal Disorders | Full Text

  https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-10-S1-S1

  The diagnosis of Chiari type I malformation in patients with or without symptoms is established with neuroimaging techniques. […] The diagnosis of syringomyelia should be made by MRI of the complete spine (cervical, dorsal, and lumbar). […] The delay from the onset of the disease to the diagnosis of any craneocervical junction malformation, before 1985 was significantly longer than after 1985 when magnetic resonance imaging became widely available in clinical practice. […] The preferred technique is magnetic resonance imaging (MRI). […] The diagnosis of Chiari type I malformation in patients with or without symptoms is established with neuroimaging techniques; the preferred technique is magnetic resonance imaging (MRI). […] The diagnosis of syringomyelia should be made by MRI of the complete spine (cervical, dorsal, and lumbar).

• #1 Syringomyelia Workup: Imaging Studies, Other Tests, Histologic Findings

  https://emedicine.medscape.com/article/1151685-workup

  The initial evaluation of patients suspected of having a spinal cord syrinx includes a comprehensive history and physical examination. […] Information obtained from examinations guides the imaging studies. Essential tests include plain radiographic series with dynamic views and high-resolution CT scan to assess the bony spinal canal. […] The most sensitive imaging test for soft tissue is an MRI scan. Gadolinium-enhanced images are also helpful in differentiating between tumor, scar, and disk material, especially in postoperative or posttraumatic cases. […] Physicians primarily use magnetic resonance imaging (MRI) to diagnose syringomyelia. […] Imaging of the entire rostrocaudal extension of the cyst or cysts is important. Gadolinium-enhanced images are indicated if a tumor is suspected. Gadolinium-enhanced images are helpful in differentiating between scar or disk material associated with a syrinx, especially in postoperative or posttraumatic cases.

• #1 Syringomyelia: What It Is, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/6126-syringomyelia

  This type of MRI can show the flow of cerebrospinal fluid (CSF) around your spinal cord and within the syrinx. It may require a contrast agent, which is injected into one of your veins, to enhance the MRI images. […] If you’re unable to undergo an MRI, a CT scan is the next choice. A myelogram is a diagnostic imaging test that uses a contrast dye and computed tomography (CT) to look for issues in your spinal canal.

• #1 Syringomyelia – multiple symptoms make diagnosis difficult – Medizinonline

  https://medizinonline.com/en/syringomyelia-multiple-symptoms-make-diagnosis-difficult/

  Syringomyelia is a rare disease that develops due to a disturbance of cerebrospinal fluid flow (CSF) and is often due to obstruction of the subarachnoid space of the spinal column. […] The rare disease is now being diagnosed more frequently as magnetic resonance imaging (MRI) is increasingly used in the routine investigation of back and neck pain. […] Magnetic resonance imaging with and without contrast medium is the preferred imaging method. The scan enables precise imaging of the relevant anatomy and accurate visualization of the syrinx in the sagittal and axial planes. […] Phase contrast MRA is used to examine the disturbance of CSF dynamics in detail. […] Myelography with high-resolution computed tomography (CT) is recommended in cases where magnetic resonance imaging is contraindicated.

• #1 Syringomyelia Workup: Imaging Studies, Other Tests, Histologic Findings

  https://emedicine.medscape.com/article/1151685-workup

  MRI examination should include sagittal and transverse views in T1 and T2 images. […] Magnetic resonance angiography can be especially helpful in cases of syringomyelia associated with vascular lesions. […] Cine phase-contrast MRI is used to analyze CSF flow dynamics near the spinal cord cyst. […] Myelography is performed in special situations when MRI cannot be used. […] Myelogram combined with immediate and delayed high-resolution CT scan also can be performed. […] In neurophysiological assessment by somatosensory evoked potentials (SSEPs), low-amplitude or delayed responses are present in myelopathy. […] Neurophysiological assessment by motor evoked response may be more sensitive than SSEPs in the evaluation of spinal cord dysfunction. […] Histopathologic findings include (1) cavitation of spinal cord gray matter, (2) syrinx continuous with or adjacent to the central canal, and (3) an inner layer of gliotic tissue.

• #1 Syringomyelia: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/ochspine/syringomyelia/treatment

  How is Syringomyelia Diagnosed? Diagnosis Your doctor will need to perform a physical exam and review your medical history before diagnosing syringomyelia. Diagnosis is then confirmed through a neurological exam and imaging tests of the brain and spine, including: […] MRIs are the most common ways to diagnose syringomyelia, as they provide a detailed view of the spine and can clearly show tumors or syrinxes. Your doctor may order a dynamic MRI, in which multiple MRIs are taken rapidly to depict how the cerebrospinal fluid flows around the spinal cord and in the syrinx. […] CT scans. Some patients who cannot get an MRI will undergo a CT scan instead, often along with a myelogram. Myelograms are imaging tests that involve a contrast dye and CT that help highlight abnormalities in your spinal cord. […] X-rays are another type of imaging test that can show abnormalities in the spine.

• #1 Syringomyelia: Symptoms, Causes, Treatment | Qwark

  https://qwarkhealth.com/conditions/syringomyelia

  Syringomyelia is diagnosed through imaging tests such as MRI and is treated with surgery. […] The common tests used to diagnose syringomyelia include magnetic resonance imaging (MRI), computed tomography (CT), myelography, and electromyography (EMG). […] MRI scans are the most sensitive and specific diagnostic tool for syringomyelia as they can provide high-resolution images of the spinal cord and identify the presence of a syrinx within the spinal cord. […] EMG tests are not used to diagnose syringomyelia directly, but they can help to identify the underlying nerve damage caused by the condition. […] Lumbar puncture is not typically used as a diagnostic tool for syringomyelia. […] X-ray imaging is not useful in the diagnosis of syringomyelia as it cannot detect the presence of a syrinx within the spinal cord.

• #1 Syringomyelia – multiple symptoms make diagnosis difficult – Medizinonline

  https://medizinonline.com/en/syringomyelia-multiple-symptoms-make-diagnosis-difficult/

  Although electromyography has no diagnostic value in syringomyelia, it helps to rule out peripheral neuropathy as a cause of paresthesias. […] The prognosis depends on factors such as the underlying cause, the degree of neurological impairment, the location and size of the syrinx cavity and a syrinx diameter of more than 5 mm together with associated edema, which often heralds rapid deterioration. […] Early detection and treatment can reverse the deformity. […] Doctors need to differentiate Chiari headaches, and a patients medical history is crucial in this regard.

• #1 Syringomyelia: What It Is, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/6126-syringomyelia

  To diagnose syringomyelia, your healthcare provider will review your medical history and perform a physical exam focusing on neurological function. […] Your provider will likely order imaging tests of your spine or brain. In some cases, healthcare providers discover syringomyelia accidentally on imaging tests that were ordered for another medical reason. […] If your healthcare provider suspects you have syringomyelia, they may recommend one or more of the following tests: […] An MRI scan is the most reliable way to diagnose syringomyelia. An MRI takes detailed pictures of structures inside your body using a large magnet and a computer. Using this test, your provider will be able to determine if there’s a syrinx in your spine or another abnormality, such as a tumor. An MRI readily reveals the location, size and extent of the syrinx.

• #1

  https://link.springer.com/article/10.1007/s10072-021-05347-3

  Syringomyelia and Chiari malformation are classified as rare diseases on Orphanet, but international guidelines on diagnostic criteria and case definition are missing. […] Aim of the study: to reach a consensus among international experts on controversial issues in diagnosis and treatment of Chiari 1 malformation and syringomyelia in adults. […] A multidisciplinary panel of the Chiari and Syringomyelia Consortium (4 neurosurgeons, 2 neurologists, 1 neuroradiologist, 1 pediatric neurologist) appointed an international Jury of experts to elaborate a consensus document. […] The Jury received a structured questionnaire containing the 63 statements, each to be voted on a 4-point Likert-type scale and commented. […] After round 2, a consensus was reached on 57/63 statements (90.5%). […] The consensus document consists of 63 statements which benefited from expert discussion and fine-tuning, serving clinicians and researchers following adults with Chiari and syringomyelia.

• #1 Syrinx | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/syrinx-1?lang=us

  Neurological symptoms vary considerably depending on where the syrinx is located in the neuraxis. Classically there is a mix of motor and sensory features, with both acute and chronic effects. […] When a syrinx is present rostrally into the neuraxis, syringomyelia is generally also present and the resultant syrinx is generally appreciated as an „extension” from this. […] Radiographic investigations may reveal many anomalies depending on the cause of the syrinx. […] The syrinx may be appreciated as an area of decreased attenuation, similar to that of CSF, within the spinal cord. […] The syrinx follows CSF signal characteristics on all sequences: T1: hypointense, T2: hyperintense, although there may be hypointense regions representing flow or pulsation artifact. […] When symptomatic, neurosurgical intervention may be required.

• #1 Syringomyelia Differential Diagnoses

  https://emedicine.medscape.com/article/1151685-differential

  Failure to recognize the symptoms of syringomyelia or attributing symptoms (pain, excess sweating, increased spasticity, numbness, or weakness) to other causes can result in morbidity, including neurologic deterioration. […] Clinicians should have a high index of suspicion for syringomyelia in any patient with SCI presenting with new onset or worsening of any of the aforementioned symptoms. […] The presence of a peripheral nerve disorder can alter the signs of myelopathy, masking both the sensory loss and distal hyperreflexia. Worsening syringomyelia could be missed in this setting.

• #1 Syringomyelia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/syringomyelia/

  MRI is the diagnostic modality of choice. […] X-ray or CT: to detect scoliosis and assess the bony spine […] MRI (confirmatory test): detection of the syrinx (may be septated) and adjacent spinal cord lesions (e.g., tumors, adhesions in arachnoiditis)

• #1 Diagnosis – Syringomyelia

  https://atlasbrain.com/syrinx/hendelman/diagnosis/diagnosis-syringomyelia.htm

  Syringomelia is a rare (prevalence 8/100,000) chronic, progressive degenerative condition in which a tubular cavitation, called a syrinx, develops within the central parenchyma of the spinal cord. […] Almost 90% of syrinxes are associated with congenital Type 1 Arnold-Chiari Malformation, while an acquired syrinx may develop subsequent to spinal cord trauma, spinal arachnoiditis, and intramedullary cord tumours (astrocytoma, hemangioblastoma, ependymoma). […] Diagnostic imaging: Myelography – widened cervical cord, eroded pedicles. […] CT – repeat scan done after a metrizamide injection into spinal cord concentrates in syrinx, revealing either expanded or collapsed cord. […] MRI – fluid-filled syrinx distinguished from intramedullary tumour.

• #1 Syringomyelia: A dangerous yet easily overlooked condition – FV Hospital

  https://www.fvhospital.com/news/syringomyelia-a-dangerous-yet-easily-overlooked-condition/

  Syringomyelia is a condition where the central canal of the spinal cord develops cysts filled with fluid. As these cysts grow, they can compress the nerve fibres connecting to different parts of the brain, causing pain, difficulty in movement, sensory disturbances, and other symptoms. […] To accurately diagnose syringomyelia, doctors will rely on advanced imaging diagnostic methods such as magnetic resonance imaging (MRI) and computed tomography (CT scan). In some cases, additional diagnostic methods may be required to differentiate syringomyelia from other conditions such as segmental sclerosis, bleeding in the spinal cord, spinal cord tumours, tabes dorsalis, or progressive muscular atrophy (Aran-Duchenne). […] The danger lies in the disease having vague symptoms, easily confused with general fatigue and weakness. As a result, patients often have to visit multiple specialists. By the time the correct diagnosis is made, the disease has progressed, leading to a challenging and prolonged treatment process. This is a medical condition where even professionals can easily make inaccurate assessments, leading patients down dead-end paths, emphasised Dr Hung.

• #1 Pediatric Syringomyelia | PM&R KnowledgeNow

  https://now.aapmr.org/pediatric-syringomyelia/

  Syringomyelia is a condition caused by a fluid-filled cavity, or syrinx, which forms within the spinal cord. […] The syrinx can span one or more spinal levels or even the entire length of the spinal cord, causing a variety of motor, sensory, and autonomic symptoms based on location. […] Syringomyelia may be congenital or acquired: […] The most common etiology of syringomyelia in both adult and pediatric patients is Chiari I malformation, representing 48-50% of adult cases and 43.2% of pediatric cases. […] Syringomyelia most commonly presents in young adults ages 20 to 40, although all ages may be affected. […] Risk factors for developing syringomyelia include a family history of syringomyelia as well as specific factors related to predisposing conditions. […] Contrast-enhanced spinal MRI is the gold standard for detection of syringomyelia.

• #1 Decoding Chiari Malformation and Syringomyelia: From Epidemiology and Genetics to Advanced Diagnosis and Management Strategies

  https://www.mdpi.com/2076-3425/13/12/1658

  Recognizing a syrinx via pre-surgery imaging, even if it does not manifest symptoms, is instrumental for surgical planning and post-surgical success evaluation. […] Tethered Cord Syndrome (TCS) is present in about 14% of CM-I patients. […] While the phrase “tethered cord” denotes a fixed segment of the spinal cord, TCS specifically alludes to the lumbar-level anchoring of the spinal cord. […] The aim of this comprehensive review is to put into perspective the classifications of Chiari malformation and related disorders, the therapy management of these pathologies and their genetic etiology. […] The search process was conducted using specific databases such as PubMed and Web of Science. […] The inclusion criteria specified articles written in English that referred to diagnostic imaging, surgical interventions, and outcomes of Chiari malformations.

• #1 Syringomyelia: diagnosis and management | Practical Neurology

  https://pn.bmj.com/content/21/5/403

  The conventional radiological criteria for diagnosing Chiari malformations are being challenged. […] The main clinical clue that a hindbrain hernia is the cause of symptoms is the nature of the patients headaches. […] A large variety of other symptoms can be associated with Chiari type 1 malformations, independent of any arising from associated syringomyelia. […] Obstruction to CSF movement in the spinal canal is most often the result of scar tissue formation in the arachnoid plane. […] Post-traumatic syringomyelia is a prime example of something quite literally adding physical insult to an existing injury. […] It could be argued that there is no such thing as idiopathic syringomyelia and that a more diligent search is required, to locate a point of obstruction in the CSF pathways.

• #1 Syringomyelia doc – Bobby Jones CSF

  https://bobbyjonescsf.org/physician-information/syringomyelia/

  Diagnosis made on MRI. Patients with congenital tethered spinal cord should undergo exploration and tethered cord release in order to prevent future neurological and urological deficits. If the syrinx is large in cross-sectional diameter, it is often drained at the same surgery. […] Diagnosis made on MRI. Spinal cord decompression with dissection of the arachnoid scar is performed. Reestablish normal CSF flow. If the arachnoiditis is so diffuse that it becomes impossible to achieve a good dissection, shunt the syrinx to the pleural or peritoneal cavities. […] Diagnosis made on MRI. Syringomyelia associated with an intrinsic spinal cord tumor often have high protein content and may represent a secretory process from the tumor cells, or an obstructive process similar to other etiologies. Patients with tumor related cysts should be treated with tumor resection.

• #1 Syringomyelia doc – Bobby Jones CSF

  https://bobbyjonescsf.org/physician-information/syringomyelia/

  In a large percentage of patients, the syrinx has no identifiable cause. Those are difficult to treat. Most large and/or symptomatic syrinxes are treated with syrinx shunting. Rarely, a posterior fossa decompression is found to be successful in the absence of a Chiari malformation. Such patients who respond to decompression are thought to have a Chiari zero. It is so far impossible to predict which patient with idiopathic syringomyelia would respond to posterior fossa decompression. The strict definition of Chiari zero is idiopathic syringomyelia that responds to posterior fossa decompression. […] The diagnosis of tethered spinal cord is made by MRI. In patients with spinal inflammation or arachnoiditis, stabilization of the syrinx can be achieved with decompression and arachnoid dissection in 83% of patients with focal scarring but only 17% of patients with scarring over multiple levels. Syrinx shunting alone results in very high recurrence rates.

• #1 Decoding Chiari Malformation and Syringomyelia: From Epidemiology and Genetics to Advanced Diagnosis and Management Strategies

  https://www.mdpi.com/2076-3425/13/12/1658

  Chiari Malformation and Syringomyelia are neurosurgical entities that have been the subject of extensive research and clinical interest. […] Key observations from canine studies offer pivotal insights into the pathogenesis of Syringomyelia and its extrapolation to human manifestations. […] Diagnostically, while traditional methods have stood the test of time, innovative neurophysiological techniques are revolutionizing early detection and management. Neuroradiology, a cornerstone in diagnosis, follows defined criteria. Advanced imaging techniques are amplifying diagnostic precision. […] A significant proportion of individuals with symptomatic CM-I, as many as 50%, might develop a syrinx. The preferred imaging method for visualizing syrinxes is sagittal MR T2-weighted scans of the entire spinal cord, supplemented by axial T2 views.

• #1 Decoding Chiari Malformation and Syringomyelia: From Epidemiology and Genetics to Advanced Diagnosis and Management Strategies

  https://www.mdpi.com/2076-3425/13/12/1658

  The extent of tonsillar descent does not necessarily align with symptom severity, as a significant portion (around 30%) of patients with pronounced tonsillar descent may not display any symptoms. […] Dynamic studies play a role in evaluating CM-I symptoms and anticipating surgical outcomes. […] Phase contrast cine MRI has pinpointed notable variances in CSF velocity in symptomatic CM-I patients. […] In symptomatic CM-I patients, unusual pulsatile actions of the cerebellar tonsils were noted, with post-surgical improvements in tonsillar pulsation amplitude and arachnoid space reduction. […] CSF dynamic investigations aim to differentiate between symptomatic and asymptomatic CM-I patients, but research outcomes have been mixed. […] The preferred imaging method for visualizing syrinxes is sagittal MR T2-weighted scans of the entire spinal cord, supplemented by axial T2 views.

• #1 Syringomyelia | PM&R KnowledgeNow

  https://now.aapmr.org/syringomyelia/

  Syringomyelia is an abnormal cystic collection of fluid, or syrinx, that forms within the parenchyma of the spinal cord. […] The diagnosis of syringomyelia is confirmed with MRI imaging. However, laboratory serum or CSF testing may be used in the workup of a syrinx of unknown etiology, particularly if there is a suspicion of spinal infection or inflammatory conditions. […] MRI is the gold standard for diagnosis of syringomyelia. Specifically, T1-, T2-, FLAIR-, T2*, and enhanced T1 sequences are used to evaluate the syrinx. […] Dynamic contrast-enhanced MRI technology enables viewing of spinal fluid pulsating within the syrinx, even before symptoms appear in syringomyelia. […] There are no evidence-based guidelines. […] The exact mechanism of syrinx development remains unknown and no prevention or cure exists. […] Although the diagnosis is easily done today with the relatively common availability of MRI scanning, it is difficult to decide what the optimal treatment strategy is for the individual patient.

• #1 Syringomyelia And Tethered Cord | Living With Paralysis

  https://www.christopherreeve.org/todays-care/living-with-paralysis/health/causes-of-paralysis/syringomyelia-tethered-cord/

  To diagnose syringomyelia, tethered cord syndrome, or both, the first step is to have a physical and neurological physical examination. […] Magnetic resonance imaging (MRI) is the main assessment of the spinal cord to look for the location of syringomyelia, tethered cord syndrome, or both. […] Syringomyelia and tethered cord syndrome diagnosis may also involve a CT scan (computer tomography), ultrasound, and endoscopy to gain more information about the location, details of involvement, and structure of the spinal cord. […] A myelogram is an X-ray with contrast material injected into the sac surrounding the spinal cord. This can help in providing information about the effects of the tethered cord. […] EMG (electromyography) and NCS (nerve conduction studies) may be completed to assess changes in muscle and nerve function. […] During surgery, specialized neuromonitoring systems are used to ensure the safety and functionality of the spinal cord during the operation.

• #1

  https://journals.lww.com/spinejournal/fulltext/2025/06010/chiari_malformation__diagnosis,_classifications,.8.aspx

  CM type 1 involves cerebellar tonsil herniation leading to neurological symptoms. […] Headache, brainstem, and/or cerebellar/brainstem symptoms/signs were confirmed as the main typical neurological hallmarks of CM. […] An accurate clinical assessment appeared to be the most reliable evaluation model available. […] Magnetic resonance imaging is the gold standard to show the extent of tonsillar herniation, overcrowded posterior fossa, or the absence of cisterna magna. […] For asymptomatic or mildly symptomatic radiologically positive patients conservative management is appropriate. […] Somatosensory, motor, brainstem auditory evoked potentials and polysomnography could be helpful to guide eventual surgical indication. […] Magnetic resonance imaging is essential for diagnosis, particularly for type 1 in adults. […] For asymptomatic or mildly symptomatic patients, conservative management is recommended.

• #1 Syringomyelia doc – Bobby Jones CSF

  https://bobbyjonescsf.org/physician-information/syringomyelia/

  Fluid-filled cavity within the spinal cord. Other nomenclature: hydromyelia, syringohydromyelia, spinal cord cyst. […] Spinal MRI shows a dilated cavity with the same intensity of CSF on T2-weighted imaging. A complete brain and spinal MRI with and without Gadolinium is needed to determine the primary pathology. Cine MRI may also help in diagnosing abnormal CSF flow patterns. So far, results have been conflicting. Rarely, myelography may help to sort some of the more difficult cases. […] Diagnosis made on MRI. Syrinx associated with Chiari I malformation is usually treated with posterior fossa decompression. If the syrinx does not resolve, one would consider (re-explore the posterior fossa and expand the decompression; consideration of subtle craniocervical instability; consideration of benign intracranial hypertension; consideration of shunting the syrinx directly; others).

• #1 Syringomyelia – Seattle Children’s

  https://www.seattlechildrens.org/conditions/syringomyelia/

  How is syringomyelia diagnosed? […] Doctors will watch for signs of syringomyelia if your child has 1 of the conditions that may cause it. […] Your childs doctor may do these tests: […] An MRI (magnetic resonance imaging) scan of your childs spine to look for the cyst. […] MRI CSF flow study to see how CSF moves in and around your child’s brain. Seattle Childrens has special computer software to make cine-MRI images. Our doctors are experienced in interpreting these images. Cine-MRI helps doctors decide who may need surgery and which type would help most. […] We offer the most advanced diagnosis and treatments. For many children, MRI (magnetic resonance imaging) is part of making an accurate diagnosis. Our doctors have the equipment and expertise to use a special MRI (cine-MRI) that shows how CSF flows in and around the brain.

• #1 Syrinx | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/syrinx-1?lang=us

  Syrinx (pl. syringes or syrinxes) is the collective name given to hydromyelia, syringomyelia, syringobulbia, syringopontia, syringomesencephaly, and syringocephalus. […] The use of the general term „syrinx” has grown out of the difficulty in distinguishing between hydromyelia and syringomyelia using imaging modalities. […] Strictly speaking, in hydromyelia, there is dilatation of the central canal of the spinal cord, and thus the lesion is lined by ependyma. While in syringomyelia there is cystic dissection through the ependymal lining of the central canal and a CSF collection within the cord parenchyma itself, and thus this lesion is not lined by ependyma. […] As clinically, there is no difference between the two, and the severity of symptoms is related to the location and size of the lesion, the word „syrinx” may be used as a general descriptor and has the benefit of brevity.

• #1 Syringomyelia | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/s/syringomyelia.html

  Syringomyelia is a disorder in which a fluid-filled cyst forms in the spinal cord. […] Other, more common disorders share the early symptoms of syringomyelia. In the past, this has made diagnosis difficult. Magnetic resonance imaging (MRI) has significantly increased the number of cases diagnosed early.

• #1 Syringomyelia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537110/

  Treatment strategies for syringomyelia include avoiding activities that increase venous pressure, such as straining, flexing the neck, and breath-holding spells, which can help alleviate symptoms by reducing pressure. […] Surgical interventions aim to correct the underlying pathophysiology causing syringomyelia, with the primary goal of improving CSF flow dynamics. […] In patients with CM-1, craniocervical decompression is often the recommended approach. […] The duration of sensory deficits before surgery significantly predicts symptomatic improvement following surgery. […] Early surgical intervention is crucial to minimize deficits and improve overall outcomes. […] The prognosis hinges on factors such as the underlying cause, the extent of neurological impairment, the location and size of the syrinx cavity, and a syrinx diameter exceeding 5 mm, along with associated edema, which often predicts rapid deterioration. […] Most studies (99%) have reported using posterior fossa/foramen magnum decompression as the primary surgical intervention. […] Postoperatively, syringomyelia improved or resolved in nearly 80% of patients.

• #1 Pediatric Syringomyelia | PM&R KnowledgeNow

  https://now.aapmr.org/pediatric-syringomyelia/

  When syringomyelia presents symptomatically, progressive neurologic deterioration may appear, but it may take years from onset to diagnosis. […] The approach of treatment is to drain the syrinx cavity, create a conduit for CSF flow and lower CSF pressure. […] Asymptomatic patients require expectant management with monitoring of MRI and clinical symptoms. […] Successful surgery for CM-I depends on early detection, which is facilitated by MRI. […] Syringomyelia is a life-long disease requiring complex management over the life span.

• #1 Syringomyelia – NDSR

  https://www.ndsr.co.uk/information-sheets/syringomyelia/

  Syringomyelia is a neurological condition where fluid filled cavities develop within the spinal cord (the bundle of nerves that run inside the spine). […] The best method of diagnosing syringomyelia is an MRI scan of the brain and spine. It is necessary to perform this investigation under a general anaesthetic. […] Not all dogs with syringomyelia will show signs of pain or other clinical symptoms, so the presence of syringomyelia can be an incidental finding on an MRI scan or specialised X-rays, when neurological investigations are being performed.

• #1 Syringomyelia | Dr. Dan Heffez Neurological Surgeon

  https://www.heffezchiari.com/syringomyelia

  Magnetic resonance imaging or MRI is the best method for detecting a syrinx. […] Symptoms of syringomyelia include numbness and decreased sensitivity to pain, heat, and cold in the arms, hands, shoulders, and upper back. […] A patient who has a syrinx and elects not to undergo treatment should be followed closely using MRI scan to ensure that the syrinx does not expand.

• #1 Syringomyelia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537110/

  Syringomyelia is a condition characterized by abnormal cerebrospinal fluid circulation, leading to the formation of fluid-filled cavities (syrinx) within the spinal cord parenchyma or central canal. […] Syringomyelia commonly presents with sensory symptoms such as pain and temperature insensitivity and is frequently discovered incidentally due to the widespread use of MRI in assessing back and neck pain. […] This activity focuses on addressing the presentation, evaluation, and management of syringomyelia in the affected patients. […] Identify the clinical manifestations, neurological symptoms, and predisposing conditions associated with syringomyelia, such as Chiari malformation, spinal cord trauma, or tumors. […] Screen patients with relevant medical history or presenting symptoms for potential syringomyelia, including those with spinal cord injuries or congenital abnormalities.

• #1 Syringomyelia: diagnosis and management | Practical Neurology

  https://pn.bmj.com/content/21/5/403

  The most fascinating and challenging aspect of syringomyelia, from the scientific perspective, is comprehending how the cavities form and then propagate. […] Large, symptomatic syrinx cavities, with an obvious underlying cause such as a Chiari malformation, invite surgical correction. […] When it comes to Chiari malformations without an associated syrinx, there is even more reason to adopt a conservative approach, in the first instance at least. […] If we do look to intervene surgically, there are three ways of trying to induce a syrinx cavity to collapse. […] If other surgical measures fail, a remaining option is to lower the overall CSF pressure with some form of CSF diversion operation. […] Despite the ease with which the diagnosis of syringomyelia can now be confirmed, and notwithstanding our better understanding of the filling mechanisms of syrinx cavities, there remain many uncertainties and several controversies regarding the condition. […] Our duty, as doctors, is to listen to and believe our patients. We must take the time to explain matters, apologising for our own deficiencies in understanding these enigmatic disorders.

• #2 Syringomyelia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537110/

  Syringomyelia is a condition characterized by abnormal cerebrospinal fluid circulation, leading to the formation of fluid-filled cavities (syrinx) within the spinal cord parenchyma or central canal. […] Syringomyelia commonly presents with sensory symptoms such as pain and temperature insensitivity and is frequently discovered incidentally due to the widespread use of MRI in assessing back and neck pain. […] This activity focuses on addressing the presentation, evaluation, and management of syringomyelia in the affected patients. […] Identify the clinical manifestations, neurological symptoms, and predisposing conditions associated with syringomyelia, such as Chiari malformation, spinal cord trauma, or tumors. […] Screen patients with relevant medical history or presenting symptoms for potential syringomyelia, including those with spinal cord injuries or congenital abnormalities.

• #2 Syringomyelia Workup: Imaging Studies, Other Tests, Histologic Findings

  https://emedicine.medscape.com/article/1151685-workup

  The initial evaluation of patients suspected of having a spinal cord syrinx includes a comprehensive history and physical examination. […] Information obtained from examinations guides the imaging studies. Essential tests include plain radiographic series with dynamic views and high-resolution CT scan to assess the bony spinal canal. […] The most sensitive imaging test for soft tissue is an MRI scan. Gadolinium-enhanced images are also helpful in differentiating between tumor, scar, and disk material, especially in postoperative or posttraumatic cases. […] Physicians primarily use magnetic resonance imaging (MRI) to diagnose syringomyelia. […] Imaging of the entire rostrocaudal extension of the cyst or cysts is important. Gadolinium-enhanced images are indicated if a tumor is suspected. Gadolinium-enhanced images are helpful in differentiating between scar or disk material associated with a syrinx, especially in postoperative or posttraumatic cases.

• #2 Diagnosing Syringomyelia – USA Spine Care – Laser Spine Surgery

  https://usaspinecare.com/spine/diagnosing-syringomyelia/

  Diagnosing syringomyelia can be challenging as the symptoms often mimic other conditions. A combination of medical history, physical examination, and imaging tests is typically required for accurate diagnosis. […] A detailed medical history is essential. Healthcare providers will inquire about the onset and progression of symptoms, including pain, weakness, numbness, and balance issues. Information about any previous injuries, surgeries, or family history of spinal conditions is also valuable. […] A thorough physical examination involves assessing reflexes, muscle strength, sensation, and coordination. Doctors may perform specific tests to evaluate spinal cord function. […] Imaging studies are crucial for diagnosing syringomyelia. The most common tests include: […] MRI provides detailed images of the spinal cord and surrounding tissues, allowing for clear visualization of the syrinx. […] Early diagnosis is crucial for effective management of syringomyelia. If you experience symptoms suggestive of this condition, its important to consult with a healthcare professional for proper evaluation.

• #2 Syringomyelia: What It Is, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/6126-syringomyelia

  To diagnose syringomyelia, your healthcare provider will review your medical history and perform a physical exam focusing on neurological function. […] Your provider will likely order imaging tests of your spine or brain. In some cases, healthcare providers discover syringomyelia accidentally on imaging tests that were ordered for another medical reason. […] If your healthcare provider suspects you have syringomyelia, they may recommend one or more of the following tests: […] An MRI scan is the most reliable way to diagnose syringomyelia. An MRI takes detailed pictures of structures inside your body using a large magnet and a computer. Using this test, your provider will be able to determine if there’s a syrinx in your spine or another abnormality, such as a tumor. An MRI readily reveals the location, size and extent of the syrinx.

• #2 Decoding Chiari Malformation and Syringomyelia: From Epidemiology and Genetics to Advanced Diagnosis and Management Strategies

  https://www.mdpi.com/2076-3425/13/12/1658

  Chiari Malformation and Syringomyelia are neurosurgical entities that have been the subject of extensive research and clinical interest. […] Key observations from canine studies offer pivotal insights into the pathogenesis of Syringomyelia and its extrapolation to human manifestations. […] Diagnostically, while traditional methods have stood the test of time, innovative neurophysiological techniques are revolutionizing early detection and management. Neuroradiology, a cornerstone in diagnosis, follows defined criteria. Advanced imaging techniques are amplifying diagnostic precision. […] A significant proportion of individuals with symptomatic CM-I, as many as 50%, might develop a syrinx. The preferred imaging method for visualizing syrinxes is sagittal MR T2-weighted scans of the entire spinal cord, supplemented by axial T2 views.

• #2 Syringomyelia – multiple symptoms make diagnosis difficult – Medizinonline

  https://medizinonline.com/en/syringomyelia-multiple-symptoms-make-diagnosis-difficult/

  Syringomyelia is a rare disease that develops due to a disturbance of cerebrospinal fluid flow (CSF) and is often due to obstruction of the subarachnoid space of the spinal column. […] The rare disease is now being diagnosed more frequently as magnetic resonance imaging (MRI) is increasingly used in the routine investigation of back and neck pain. […] Magnetic resonance imaging with and without contrast medium is the preferred imaging method. The scan enables precise imaging of the relevant anatomy and accurate visualization of the syrinx in the sagittal and axial planes. […] Phase contrast MRA is used to examine the disturbance of CSF dynamics in detail. […] Myelography with high-resolution computed tomography (CT) is recommended in cases where magnetic resonance imaging is contraindicated.

• #2 Syringomyelia Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/syringomyelia

  Syringomyelia is a condition in which a syrinx (a cyst, or collection of fluid) forms in the spinal cord. […] If a patient presents with symptoms associated with syringomyelia, the surgeon may order a magnetic resonance imaging (MR) scan. MR scans use a combination of large magnets, radio waves, and a computer to produce detailed images of organs and structures within the body. A special type of MR called a cine MR may also be useful. More like a video than a still image, the cine MR can show the movement of cerebrospinal fluid. Computed tomography (CT) scan can also be useful. They use a computer and multiple X-rays to produce detailed images of bones and soft tissues. They can help diagnose syrinxes, tumors (occasionally a cause of syringomyelia), or hydrocephalus (a buildup of cerebrospinal fluid in the brain).

• #2 Decoding Chiari Malformation and Syringomyelia: From Epidemiology and Genetics to Advanced Diagnosis and Management Strategies

  https://www.mdpi.com/2076-3425/13/12/1658

  The extent of tonsillar descent does not necessarily align with symptom severity, as a significant portion (around 30%) of patients with pronounced tonsillar descent may not display any symptoms. […] Dynamic studies play a role in evaluating CM-I symptoms and anticipating surgical outcomes. […] Phase contrast cine MRI has pinpointed notable variances in CSF velocity in symptomatic CM-I patients. […] In symptomatic CM-I patients, unusual pulsatile actions of the cerebellar tonsils were noted, with post-surgical improvements in tonsillar pulsation amplitude and arachnoid space reduction. […] CSF dynamic investigations aim to differentiate between symptomatic and asymptomatic CM-I patients, but research outcomes have been mixed. […] The preferred imaging method for visualizing syrinxes is sagittal MR T2-weighted scans of the entire spinal cord, supplemented by axial T2 views.

• #2 Syrinx | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/syrinx-1?lang=us

  Neurological symptoms vary considerably depending on where the syrinx is located in the neuraxis. Classically there is a mix of motor and sensory features, with both acute and chronic effects. […] When a syrinx is present rostrally into the neuraxis, syringomyelia is generally also present and the resultant syrinx is generally appreciated as an „extension” from this. […] Radiographic investigations may reveal many anomalies depending on the cause of the syrinx. […] The syrinx may be appreciated as an area of decreased attenuation, similar to that of CSF, within the spinal cord. […] The syrinx follows CSF signal characteristics on all sequences: T1: hypointense, T2: hyperintense, although there may be hypointense regions representing flow or pulsation artifact. […] When symptomatic, neurosurgical intervention may be required.

• #2 Syringomyelia| Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/syringomyelia

  A syringomyelia diagnosis often follows a routine physical examination and imaging test. Your doctor may use magnetic resonance imaging (MRI) or a computerized tomography (CT) scan. […] An MRI uses radio waves to take images of your spine. An MRI is the most common way to identify and diagnose syringomyelia. […] A CT scan takes a series of X-ray images of your spine. A CT scan can show tumors or other spinal cord abnormalities.

• #2 Syringomyelia: What It Is, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/6126-syringomyelia

  This type of MRI can show the flow of cerebrospinal fluid (CSF) around your spinal cord and within the syrinx. It may require a contrast agent, which is injected into one of your veins, to enhance the MRI images. […] If you’re unable to undergo an MRI, a CT scan is the next choice. A myelogram is a diagnostic imaging test that uses a contrast dye and computed tomography (CT) to look for issues in your spinal canal.

• #2 Syringomyelia Workup: Imaging Studies, Other Tests, Histologic Findings

  https://emedicine.medscape.com/article/1151685-workup

  MRI examination should include sagittal and transverse views in T1 and T2 images. […] Magnetic resonance angiography can be especially helpful in cases of syringomyelia associated with vascular lesions. […] Cine phase-contrast MRI is used to analyze CSF flow dynamics near the spinal cord cyst. […] Myelography is performed in special situations when MRI cannot be used. […] Myelogram combined with immediate and delayed high-resolution CT scan also can be performed. […] In neurophysiological assessment by somatosensory evoked potentials (SSEPs), low-amplitude or delayed responses are present in myelopathy. […] Neurophysiological assessment by motor evoked response may be more sensitive than SSEPs in the evaluation of spinal cord dysfunction. […] Histopathologic findings include (1) cavitation of spinal cord gray matter, (2) syrinx continuous with or adjacent to the central canal, and (3) an inner layer of gliotic tissue.

• #2 Syringomyelia – multiple symptoms make diagnosis difficult – Medizinonline

  https://medizinonline.com/en/syringomyelia-multiple-symptoms-make-diagnosis-difficult/

  Although electromyography has no diagnostic value in syringomyelia, it helps to rule out peripheral neuropathy as a cause of paresthesias. […] The prognosis depends on factors such as the underlying cause, the degree of neurological impairment, the location and size of the syrinx cavity and a syrinx diameter of more than 5 mm together with associated edema, which often heralds rapid deterioration. […] Early detection and treatment can reverse the deformity. […] Doctors need to differentiate Chiari headaches, and a patients medical history is crucial in this regard.

• #2 Syringomyelia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537110/

  Treatment strategies for syringomyelia include avoiding activities that increase venous pressure, such as straining, flexing the neck, and breath-holding spells, which can help alleviate symptoms by reducing pressure. […] Surgical interventions aim to correct the underlying pathophysiology causing syringomyelia, with the primary goal of improving CSF flow dynamics. […] In patients with CM-1, craniocervical decompression is often the recommended approach. […] The duration of sensory deficits before surgery significantly predicts symptomatic improvement following surgery. […] Early surgical intervention is crucial to minimize deficits and improve overall outcomes. […] The prognosis hinges on factors such as the underlying cause, the extent of neurological impairment, the location and size of the syrinx cavity, and a syrinx diameter exceeding 5 mm, along with associated edema, which often predicts rapid deterioration. […] Most studies (99%) have reported using posterior fossa/foramen magnum decompression as the primary surgical intervention. […] Postoperatively, syringomyelia improved or resolved in nearly 80% of patients.

• #2 Syringomyelia: diagnosis and management | Practical Neurology

  https://pn.bmj.com/content/21/5/403

  The conventional radiological criteria for diagnosing Chiari malformations are being challenged. […] The main clinical clue that a hindbrain hernia is the cause of symptoms is the nature of the patients headaches. […] A large variety of other symptoms can be associated with Chiari type 1 malformations, independent of any arising from associated syringomyelia. […] Obstruction to CSF movement in the spinal canal is most often the result of scar tissue formation in the arachnoid plane. […] Post-traumatic syringomyelia is a prime example of something quite literally adding physical insult to an existing injury. […] It could be argued that there is no such thing as idiopathic syringomyelia and that a more diligent search is required, to locate a point of obstruction in the CSF pathways.

• #2 Syringomyelia | National Institute of Neurological Disorders and Stroke

  https://www.ninds.nih.gov/health-information/disorders/syringomyelia

  A physician will review your medical history, perform a physical exam focusing on neurological function, and order imaging of the spine or brain. […] Magnetic resonance imaging (MRI) is the most reliable way to diagnose syringomyelia. Using this test, a physician can determine if a syrinx exists in the spine or if another abnormality exists, such as a tumor. […] NIH-funded researchers are working to improve diagnostic imaging techniques to better visualize spine conditions, including syringomyelia even before symptoms appear.

• #3 Syringomyelia: Symptoms, Causes, Diagnosis, Treatment

  https://www.webmd.com/brain/what-is-syringomyelia

  Doctors use magnetic resonance imaging (MRI) scans of the brain and spine to see if you have syringomyelia. The MRI can show a cyst or other condition. […] Sometimes, doctors discover you have this condition when doing an MRI for another health reason. […] You might also have a kind of X-ray procedure called a CT scan of your spine.

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