Transient oedema of the cervical spinal cord

Transient but very intense oedema of the cervical spinal cord was observed in two patients with obstruction of the cerebrospinal fluid (CSF) pathways. Both presented with hydrocephalus, one due to an infratentorial obstructin g mass and the other due to postmeningitic adhesive obstruction of the outl et foramina of the fourth ventricle. In animal experiments with obstruction of CSF pathways (due to outlet foramina obstruction or to downward tentori al herniation) flattening and stretching of the ependymal cells along the c entral canal is observed, followed by disruption and splitting of the epend ymal lining and then by extracellular oedema of the subependymal tissue. Wi thout treatment, frank cavity formation develops in a fourth stage. In our two patients, however, most probably because of appropriate decompressive t herapy, the oedema disappeared completely without a residual spinal cord le sion.