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Syringomylia and Hydrocephalus - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Brain and Spine
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1777 Questions
User :   Hi Doctor, My sis has been diagnosed wit a situation where her brain did not move upward in the head as she grew, and as such, sits on top of the spinal chord, blocking the movement of fluid. The CSF has been collecting within the spine, and the MRI shows that the thickness of the spinal chord is less than what it should be, and that the center of the spine is filled with the fluid which has been exerting pressure on the spinal wall.What is this called, and what are the options for her?
Doctor :   Hi
User :   Hi Doctor, I am AAAAAAA
Doctor :   let me read ur query
User :   thanks
Doctor :   Hello AAAAAAA
User :   Yes, Doctor...
Doctor :   so u mean , its hydrocephalus ?
User :   I am sorry - I do not know that term
Doctor :   hydrocephalus, is due to collection of CSF due to block in its secretory pathways
User :   Ok.... what we were told as a diagnosis is that it is blocked at the top by the brain being lower than it should be... during developmental growth, I was told the brain moves higher... but it has not moved as high in my sister's case
Doctor :   may i know her age ?
User :   Also, my sister has had scoliosis during her teens, and the curvature was identified at an early stage and is only evident when she wears tight body-hugging clothes.
User :   she is 26 now
User :   could u let me know if it indeed is hydrocephalus?
Doctor :   the description is very vague that has given to me
User :   how can I give more pertinent data?
User :   please ask me specific questions, keeping it simple for me to respond, and I shall answer as best I can
Doctor :   OK
Doctor :   WAS your sister born normally and at 9 months ?
User :   ceasarean, and 2 weeks before the due date...
User :   she was one of two non-identical twins
Doctor :   what about the second twin (the other twin)?
User :   She has never had any health issues ....
Doctor :   the description could fit the condition called syringomylia
User :   What is that?
Doctor :   it is a condition where in there is degeneration in the spinal cord, and colection of CSF within it
Doctor :   this increass the prssure and causes symptoms
User :   do the symptoms include flat palms
User :   and less grip laterally between the digits of a hand
Doctor :   yes
User :   that is it then
Doctor :   yes
User :   The doctor did write the name of the problem for me to google - but i was iunable to decipher the handwriting
Doctor :   can u tell me more of her symptoms and MRI findings if any ?
User :   what is the recommended course of action, Doctor
User :   Actually she was crossing the road and hit by a car.
User :   CT scans turne dout fine, and all she suffered was a concussion for a few days...
User :   this happened one week ago
Doctor :   ok
User :   however, today was the last day of the recuperation and she complained that she had pain in her neck. The doc suspected cervical and had MRI done
User :   that is when this emerged
Doctor :   so now she does not have any other symptoms ?
User :   The doctor said that this perhaps gave rise to scoliosis, or it happened the other way round
User :   none that were spoken of....
User :   what other symptoms could there be?
User :   I have read it on Wikipedia....
Doctor :   about what ?
User :   and she does have some tingling and a distinct but not by much numbness at times in her arm - I forget if it is the right or left
User :   this was attributed for a long time to her scoiliosis
User :   I mean I read possible symptoms on Wikipedia.....
User :   but no speech issues.
Doctor :   there are lot of problems which can give scoliosis along with CNS malformatioons
User :   and the shoulder pain has only beeen because of the recent collision - it is a muscle tear
User :   Ok
Doctor :   your docs, must have been speakng baout the chiari malformation
User :   I though scoliosis was idiopathic
Doctor :   no
User :   I am sorry - what is the chiari?
Doctor :   many developmental issues can cause scoliosis
User :   and CNS?
Doctor :   CNS = central nervous system (brain and spinal cord )
User :   Oh ok... right
Doctor :   sorry too much of medical short forms
User :   no this was simple
User :   I'd been a bio student - should have remembered
User :   But 'Chiari'?
Doctor :   This malformation occurs during fetal development and is characterized by downward displacement of the lower part of the brain (cerebellar tonsils) beneath the foramen magnum, into the cervical spinal canal.
User :   That is what was written in the MRI scan too
User :   I could not remember it
User :   Foramen Magnum
Doctor :   This displacement blocks the normal flow of cerebrospinal fluid. When normal flow is obstructed, a syrinx can form in the spinal cord.
User :   ok
User :   what are the implications?
User :   as this means this has been on for 26 years now
Doctor :   a cavity filled with CSF is known as a syrinx.
Doctor :   Syringomyelia can also occur as a complication of trauma, meningitis, tumor, arachnoiditis, or a tethered spinal cord.
Doctor :   n these cases the syrinx forms in the section of the spinal cord damaged by these conditions
User :   What does a tethered spinal cord mean???
User :   Could the Syringomyelia occur due to scoliosis?
Doctor :   tethered spinal cord - is injury induced fibrosis resulting in fixation of a spinal cord to a specific vertebral space
User :   or is that unrelated?
Doctor :   no it does not occur due to scoliosis
User :   oh ok
User :   The diagnosis has been that there needs to be a surgery - a removal of the rear half of the 1st spinal vertebrae, and an increase in the curvature at the base of the skull where the spine and the skull meet.
User :   and the excess fluid - or so is my understanding will be drained (I may be mistaken in this understanding)
User :   We have been asked to get more opinions and to get the surgery done as early as possible
Doctor :   is this for scoliosis or for the chiari defects ?
User :   Does the spinal wall thicken after surgery, is there a chance of this recurring, what are the long term effects of Syringomyelia?
Doctor :   i guess they are trying to do a posterior fossa decompression
User :   this is for Syringomyelia
User :   yes... I think that is what was stated .. I think
User :   in fact I am sure of it
Doctor :   ok
Doctor :   no that does not occur
Doctor :   i mean the thickening
Doctor :   posterior fossa decompression allows the cerebellar tonsils to move into a normal position, restoring the normal flow. After this procedure the syrinx will often reduce or resolve on its own.
Doctor :   i hope i have answered ur queries
Doctor :   Are u there ?
User :   Yes I am , Doctor
User :   I was also reading up on the surgery section at Wikipedia
Doctor :   ok
User :   How effective is this posterior fossa decomp?
User :   what chances of relapse are there
User :   and
User :   what are the long term implications?
Doctor :   the effects vary with patients
Doctor :   some patients recover well and have no further issues
Doctor :   some may need additional surgeries
Doctor :   experince of the surgeion as well as the severity of the underlying condition matter most in this regard
User :   can you give me a percentage... for people needing further surgeries?
Doctor :   may be 20%
Doctor :   it seems that you have moved out of the chat session due to end of the chat time
Doctor :   please log in again if u have any other medical query
Doctor :   take care and bye for now
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