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Spine
Diagnosis
Trauma
Cord, Dura, and Vessels
Presyrinx Edema
Presyrinx Edema
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Presyrinx state, interstitial cord edema

          • Definitions

            • Potentially reversible state of spinal cord edema caused by obstruction or alteration of normal CSF flow pathways
            • ± presence of syrinx

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      CLINICAL ISSUES

                      • Presentation

                        • Treatment

                          DIAGNOSTIC CHECKLIST

                          • Consider

                            Selected References

                            1. Gadde JA et al: Anatomical features of the cervical spinal canal in Chiari I deformity with presyrinx: a case-control study. Neuroradiol J. 30(5):405-9, 2017
                            2. Nixon JN et al: Presyrinx in a child with acquired Chiari I malformation. Pediatr Radiol. 43(4):506-11, 2013
                            3. Battal B et al: Cerebrospinal fluid flow imaging by using phase-contrast MR technique. Br J Radiol. 84(1004):758-65, 2011
                            4. Sekula RF Jr et al: The pathogenesis of Chiari I malformation and syringomyelia. Neurol Res. 33(3):232-9, 2011
                            5. Shaffer N et al: Cerebrospinal fluid hydrodynamics in type I Chiari malformation. Neurol Res. 33(3):247-60, 2011
                            6. Suzuki F et al: Subacute subdural hygroma and presyrinx formation after foramen magnum decompression with duraplasty for Chiari type 1 malformation. Neurol Med Chir (Tokyo). 51(5):389-93, 2011
                            7. Bonfield CM et al: Surgical management of post-traumatic syringomyelia. Spine (Phila Pa 1976). 35(21 Suppl):S245-58, 2010
                            8. Koyanagi I et al: Pathogenesis of syringomyelia associated with Chiari type 1 malformation: review of evidences and proposal of a new hypothesis. Neurosurg Rev. 33(3):271-84; discussion 284-5, 2010
                            9. Fernández AA et al: Malformations of the craniocervical junction (Chiari type I and syringomyelia: classification, diagnosis and treatment). BMC Musculoskelet Disord. 10 Suppl 1:S1, 2009
                            10. Ravaglia S et al: Presyrinx in children with Chiari malformations. Neurology. 72(22):1966-7, 2009
                            11. Yurube T et al: The vanishment of an intramedullary high-signal intensity lesion at the craniocervical junction after surgical treatment: a case report of the presyrinx state. Spine (Phila Pa 1976). 34(6):E235-9, 2009
                            12. Goh S et al: Presyrinx in children with Chiari malformations. Neurology. 71(5):351-6, 2008
                            13. Brodbelt A et al: CSF pathways: a review. Br J Neurosurg. 21(5):510-20, 2007
                            14. Ikushima I et al: High-resolution constructive interference in a steady state imaging of cervicothoracic adhesive arachnoiditis. J Comput Assist Tomogr. 31(1):143-7, 2007
                            15. Gan YC et al: Presyrinx state. J Neurosurg. 105(2 Suppl):156-7; author reply 157-9, 2006
                            16. Nair N et al: Cervical cord presyrinx. Br J Neurosurg. 20(3):175-6, 2006
                            17. Fischbein NJ et al: The "presyrinx" state: is there a reversible myelopathic condition that may precede syringomyelia? Neurosurg Focus. 8(3):E4, 2000
                            18. Milhorat TH: Is reversible enlargement of the spinal cord a presyrinx state? AJNR Am J Neuroradiol. 20(1):21-2, 1999
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Imaging

                                • Top Differential Diagnoses

                                  • Diagnostic Checklist

                                    TERMINOLOGY

                                    • Synonyms

                                      • Presyrinx state, interstitial cord edema

                                    • Definitions

                                      • Potentially reversible state of spinal cord edema caused by obstruction or alteration of normal CSF flow pathways
                                      • ± presence of syrinx

                                    IMAGING

                                    • General Features

                                      • CT Findings

                                        • MR Findings

                                          • Imaging Recommendations

                                            DIFFERENTIAL DIAGNOSIS

                                              PATHOLOGY

                                              • General Features

                                                CLINICAL ISSUES

                                                • Presentation

                                                  • Treatment

                                                    DIAGNOSTIC CHECKLIST

                                                    • Consider

                                                      Selected References

                                                      1. Gadde JA et al: Anatomical features of the cervical spinal canal in Chiari I deformity with presyrinx: a case-control study. Neuroradiol J. 30(5):405-9, 2017
                                                      2. Nixon JN et al: Presyrinx in a child with acquired Chiari I malformation. Pediatr Radiol. 43(4):506-11, 2013
                                                      3. Battal B et al: Cerebrospinal fluid flow imaging by using phase-contrast MR technique. Br J Radiol. 84(1004):758-65, 2011
                                                      4. Sekula RF Jr et al: The pathogenesis of Chiari I malformation and syringomyelia. Neurol Res. 33(3):232-9, 2011
                                                      5. Shaffer N et al: Cerebrospinal fluid hydrodynamics in type I Chiari malformation. Neurol Res. 33(3):247-60, 2011
                                                      6. Suzuki F et al: Subacute subdural hygroma and presyrinx formation after foramen magnum decompression with duraplasty for Chiari type 1 malformation. Neurol Med Chir (Tokyo). 51(5):389-93, 2011
                                                      7. Bonfield CM et al: Surgical management of post-traumatic syringomyelia. Spine (Phila Pa 1976). 35(21 Suppl):S245-58, 2010
                                                      8. Koyanagi I et al: Pathogenesis of syringomyelia associated with Chiari type 1 malformation: review of evidences and proposal of a new hypothesis. Neurosurg Rev. 33(3):271-84; discussion 284-5, 2010
                                                      9. Fernández AA et al: Malformations of the craniocervical junction (Chiari type I and syringomyelia: classification, diagnosis and treatment). BMC Musculoskelet Disord. 10 Suppl 1:S1, 2009
                                                      10. Ravaglia S et al: Presyrinx in children with Chiari malformations. Neurology. 72(22):1966-7, 2009
                                                      11. Yurube T et al: The vanishment of an intramedullary high-signal intensity lesion at the craniocervical junction after surgical treatment: a case report of the presyrinx state. Spine (Phila Pa 1976). 34(6):E235-9, 2009
                                                      12. Goh S et al: Presyrinx in children with Chiari malformations. Neurology. 71(5):351-6, 2008
                                                      13. Brodbelt A et al: CSF pathways: a review. Br J Neurosurg. 21(5):510-20, 2007
                                                      14. Ikushima I et al: High-resolution constructive interference in a steady state imaging of cervicothoracic adhesive arachnoiditis. J Comput Assist Tomogr. 31(1):143-7, 2007
                                                      15. Gan YC et al: Presyrinx state. J Neurosurg. 105(2 Suppl):156-7; author reply 157-9, 2006
                                                      16. Nair N et al: Cervical cord presyrinx. Br J Neurosurg. 20(3):175-6, 2006
                                                      17. Fischbein NJ et al: The "presyrinx" state: is there a reversible myelopathic condition that may precede syringomyelia? Neurosurg Focus. 8(3):E4, 2000
                                                      18. Milhorat TH: Is reversible enlargement of the spinal cord a presyrinx state? AJNR Am J Neuroradiol. 20(1):21-2, 1999