Abstract
It is relatively common to occur in a Tertiary Care Neurosurgical setup to get a case of Syringomyelia proximal or distal to a space-occupying lesion (SOL) or site of spinal cord compression. In this case series, we are presenting two cases in which syringomyelia developed after traumatic spinal cord injury. On initial radiological investigations, the first case presented as an old D12 fracture with Post-traumatic syrinx formation but on complete workup for the extent of the syrinx, another lesion was found incidentally in the form of an intradural extramedullary SOL at the level of cervicomedullary junction. The SOL turned out histologically as WHO Grade I Meningioma. The second case presented as syrinx formation after gunshot (fire-arm) penetrating spinal cord injury to the D11-12 vertebrae. Treatment plans of both these patients are presented here in detail along with the literature review.
Highlights
Syringomyelia is defined as the formation of abnormal fluid-filled cavity or syrinx within spinal cord parenchyma containing cerebrospinal fluid (CSF), secondary to spinal cord compression.[1]
Traumatic spinal cord injury(SCI)can cause a late,relatively uncommon, but potentially harmful complication known as Post-traumatic syringomyelia (PTS)
We report two cases of Post-traumatic syringomyelia: one caused by D12 vertebral fracture with an incidental finding of meningioma at cervicomedullary junction while evaluating for the upper extent of the syrinx andthe second caused by gunshot injury to D1112 vertebrae causing complete spinal cord injury and syrinx formation from D12 up to C2 vertebral level
Summary
Syringomyelia is defined as the formation of abnormal fluid-filled cavity or syrinx within spinal cord parenchyma containing cerebrospinal fluid (CSF), secondary to spinal cord compression.[1]. MRI whole spine plain was done at 3rd Post-operative day following bullet removal, which showed syrinx formation in spinal cord parenchyma extending from C3 to spinal cord injury at D12 level (Figure 9, 10). Figure-9: MRI Cervical Spine plain showing Syrinx formation in Spinal Cord parenchyma extending from C2-C3 to upper dorsal spine. Figure-10: MRI Dorso-lumbar Spine plain showing complete spinal cord injury at D12 level with Syrinx formation in Spinal Cord parenchyma extending upwards from cord injury. The patient was followed up after 1 week of discharge in OPD, Stitches removed and examination was done that revealed improvement in breathing and neurological symptoms: improved power in all myotomes of both upper limbs (Power Grade from 3/5 to 5/5) with normal sensations in dermatomes upto D12 bilaterally. Patient is stable with intact neurology in the upper limp since last more than 2 years
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