Y. Takamura et al., A craniocervical injury-induced syringomyelia caused by central canal dilation secondary to acquired tonsillar herniation, J NEUROSURG, 95(1), 2001, pp. 122-127
The authors report on a 19-year-old man with an acquired tonsillar herniati
on caused by a craniocervical junction injury in which serial magnetic reso
nance (MR) images demonstrated patent and isolated segments of the central
canal participating in the dilation and then formation of a cervical syrinx
. The patient was involved in a motor vehicle accident; he developed tonsil
lar herniation as a complication of subarachnoid and epidural hemorrhage, p
redominantly observed around the cisterna magna and upper cervical canal. R
epeated MR images obtained over an II month period indicated the formation
and acute enlargement of the syrinx. Ten months after the accident, the pat
ient presented with sensory disturbance in both upper extremities and spast
icity due to syringomyelia. He underwent craniocervical decompressive surge
ry and duraplasty, which reduced the size of syringomyelia. The authors pos
tulate that the patent central canal may play a role in determining the loc
ation of a syrinx remote from a focus of cerebrospinal fluid obstruction.