Syringomyelia

Magnetic resonance imaging (MRI) has revolutionized our understanding of many neurological diseases. This is the first textbook on syringomyelia by a single team of authors since the introduction of this imaging modality. Based on a pathophysiological concept which is presented in the opening chapters of this book, we provide guidelines for diagnosis and surgical treatment of patients with syringomyelia. Syringomyelia is a manifestation of cerebrospinal fluid (CSF) flow obstruction, spinal cord tethering, or a spinal cord tumor. Therefore, an underlying pathology characterized by at least one of these features can be identified for every patient. Each entity which may lead to syringomyelia is described in a separate chapter, covering clincial presentations, neuroradiological features, neurophysiology, surgical indications and techniques and a detailed analysis of postoperative results. Special sections are devoted to patients in whom surgical treatment failed initially. This book should help any physician dealing with a patient with syringomyelia to initiate the appropriate diagnostic test and studies to identify the underlying disorder. Based on the analyses of postoperative outcomes for each of these disorders, the patient may be advised to either undergo surgery or to continue conservative treatment. Neurosurgeons are given precise guidelines for surgical indications and strategies. Microsurgical techniques are illustrated step by step and include detailed intraoperative photographs.

1 Introduction. - 1. 1 Definitions of Cord Cavitations. - 1. 2 History of Syringomyelia. - References. - 2 The Pathophysiology of Syringomyelia. - 2. 1 Anatomical Background. - 2. 2 Fluid Movements in the Extracellular and Subarachnoid Spaces. - 2. 3 Tethered Cord and Extracellular Space. - 2. 4 Pathophysiological Concept. - 2. 5 Disorders Associated with Syringomyelia. - References. - 3 Syringomyelia Associated with Diseases at the Craniocervical Junction. - 3. 1 Chiari Malformations. - References. - 3. 2 Rhombencephalic Malformations. - References. - 3. 3 Foramen Magnum Arachnoiditis. - References. - 3. 4 Intracranial Tumors. - References. - 4 Syringomyelia Associated with Diseases of the Spinal Canal. - 4. 1 Syringomyelia Related to Spinal Arachnoid Scarring. - References. - 4. 2 Syringomyelia Related to Tumors of the Spinal Canal. - References. - References. - 4. 4 Syringomyelia Related to Diseases of the Spine. - References.