SYRINX EXTENDING FROM CONUS MEDULLARIS TO BASAL GANGLIA - A CLINICAL,RADIOLOGICAL, AND PATHOLOGICAL CORRELATION

A 41-year-old woman with a history of birth injury to the brachial ple xus suffered several delayed episodes of neurological deterioration. M agnetic resonance imaging studies revealed a syrinx extending from the conus medullaris into the brainstem and rostrally into both internal capsules. She died of an acute exacerbation of chronic respiratory fai lure. Autopsy demonstrated syringomyelia and syringobulbia with cavity extension bilaterally along the corticospinal tracts into the interna l capsules. Islands of glial tissue in the subarachnoid space around t he medulla caused obstruction of the subarachnoid space at the foramen magnum. These were probably the result of birth injury to the cerebel lum. A detailed clinico-pathological correlation is provided to explai n her neurological deficits. The pathogenesis of syrinx formation is d iscussed in terms of a late manifestation of birth trauma.