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Post-Traumatic Syrinx
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Post-traumatic syrinx (PTS)
            • Synonyms

              • Syringomyelia, syringohydromyelia
            • Definitions

              • Cystic cord cavity that may (hydromyelia) or may not (syringomyelia) communicate with central canal
                • Artificial distinction → syringomyelia is commonly used term
              • PTS implies syrinx formation is related to prior trauma
                • Syrinx may occur in post-trauma patients with complete recovery from trauma, and patients without direct cord injury
              • Cephalad extension to brainstem medulla is termed syringobulbia

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Nonvascular Interventions

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Klekamp J: Treatment of posttraumatic syringomyelia. J Neurosurg Spine. 17(3):199-211, 2012
                                            2. Fehlings MG et al: Posttraumatic syringomyelia. J Neurosurg Spine. 14(5):570-2; discussion 572, 2011
                                            3. Aghakhani N et al: Surgical treatment of posttraumatic syringomyelia. Neurosurgery. 66(6):1120-7; discussion 1127, 2010
                                            4. Ewelt C et al: Impact of cordectomy as a treatment option for posttraumatic and non-posttraumatic syringomyelia with tethered cord syndrome and myelopathy. J Neurosurg Spine. 13(2):193-9, 2010
                                            5. Falci SP et al: Posttraumatic spinal cord tethering and syringomyelia: surgical treatment and long-term outcome. J Neurosurg Spine. 11(4):445-60, 2009
                                            6. Reis AJ: New surgical approach for late complications from spinal cord injury. BMC Surg. 6:12, 2006
                                            7. Vannemreddy SS et al: Posttraumatic syringomyelia: predisposing factors. Br J Neurosurg. 16(3):276-83, 2002
                                            8. Lee TT et al: Outcome after surgical treatment of progressive posttraumatic cystic myelopathy. J Neurosurg. 92(2 Suppl):149-54, 2000
                                            9. Jinkins JR et al: MR of parenchymal spinal cord signal change as a sign of active advancement in clinically progressive posttraumatic syringomyelia. AJNR Am J Neuroradiol. 19(1):177-82, 1998
                                            10. Perrouin-Verbe B et al: Post-traumatic syringomyelia and post-traumatic spinal canal stenosis: a direct relationship: review of 75 patients with a spinal cord injury. Spinal Cord. 36(2):137-43, 1998
                                            11. Kramer KM et al: Posttraumatic syringomyelia: a review of 21 cases. Clin Orthop. (334):190-9, 1997
                                            12. Schurch B et al: Post-traumatic syringomyelia (cystic myelopathy): a prospective study of 449 patients with spinal cord injury. J Neurol Neurosurg Psychiatry. 60(1):61-7, 1996
                                            13. Falcone S et al: Progressive posttraumatic myelomalacic myelopathy: imaging and clinical features. AJNR Am J Neuroradiol. 15(4):747-54, 1994
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Post-traumatic syrinx (PTS)
                                                      • Synonyms

                                                        • Syringomyelia, syringohydromyelia
                                                      • Definitions

                                                        • Cystic cord cavity that may (hydromyelia) or may not (syringomyelia) communicate with central canal
                                                          • Artificial distinction → syringomyelia is commonly used term
                                                        • PTS implies syrinx formation is related to prior trauma
                                                          • Syrinx may occur in post-trauma patients with complete recovery from trauma, and patients without direct cord injury
                                                        • Cephalad extension to brainstem medulla is termed syringobulbia

                                                      IMAGING

                                                      • General Features

                                                        • Radiographic Findings

                                                          • CT Findings

                                                            • MR Findings

                                                              • Ultrasonographic Findings

                                                                • Nonvascular Interventions

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Gross Pathologic & Surgical Features

                                                                          • Microscopic Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Klekamp J: Treatment of posttraumatic syringomyelia. J Neurosurg Spine. 17(3):199-211, 2012
                                                                                      2. Fehlings MG et al: Posttraumatic syringomyelia. J Neurosurg Spine. 14(5):570-2; discussion 572, 2011
                                                                                      3. Aghakhani N et al: Surgical treatment of posttraumatic syringomyelia. Neurosurgery. 66(6):1120-7; discussion 1127, 2010
                                                                                      4. Ewelt C et al: Impact of cordectomy as a treatment option for posttraumatic and non-posttraumatic syringomyelia with tethered cord syndrome and myelopathy. J Neurosurg Spine. 13(2):193-9, 2010
                                                                                      5. Falci SP et al: Posttraumatic spinal cord tethering and syringomyelia: surgical treatment and long-term outcome. J Neurosurg Spine. 11(4):445-60, 2009
                                                                                      6. Reis AJ: New surgical approach for late complications from spinal cord injury. BMC Surg. 6:12, 2006
                                                                                      7. Vannemreddy SS et al: Posttraumatic syringomyelia: predisposing factors. Br J Neurosurg. 16(3):276-83, 2002
                                                                                      8. Lee TT et al: Outcome after surgical treatment of progressive posttraumatic cystic myelopathy. J Neurosurg. 92(2 Suppl):149-54, 2000
                                                                                      9. Jinkins JR et al: MR of parenchymal spinal cord signal change as a sign of active advancement in clinically progressive posttraumatic syringomyelia. AJNR Am J Neuroradiol. 19(1):177-82, 1998
                                                                                      10. Perrouin-Verbe B et al: Post-traumatic syringomyelia and post-traumatic spinal canal stenosis: a direct relationship: review of 75 patients with a spinal cord injury. Spinal Cord. 36(2):137-43, 1998
                                                                                      11. Kramer KM et al: Posttraumatic syringomyelia: a review of 21 cases. Clin Orthop. (334):190-9, 1997
                                                                                      12. Schurch B et al: Post-traumatic syringomyelia (cystic myelopathy): a prospective study of 449 patients with spinal cord injury. J Neurol Neurosurg Psychiatry. 60(1):61-7, 1996
                                                                                      13. Falcone S et al: Progressive posttraumatic myelomalacic myelopathy: imaging and clinical features. AJNR Am J Neuroradiol. 15(4):747-54, 1994