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Japanese

CLINICAL AND NEURORADIOLOGICAL FEATURES OF SYRINGOMYELIA ASSOCIATED WITH CHIARI MALFORMATION Toyohiko Isu 1 , Yoshinobu Iwasaki 1 , Minoru Akino 1 , Hiroshi Abe 1 , Kunio Tashiro 2 , Kazumasa Sudo 2 , Kazuo Miyasaka 3 , Hisatoshi Saito 4 1Department of Neurosurgery, University of Hokkaido School of Medicine 2Department of Neurology, University of Hokkaido School of Medicine 3Department of Radiology, University of Hokkaido School of Medicine 4Sapporo Azabu Neurosurgical Hospital Keyword: Chiari malformation , magnetic resonance image , syringomyelia pp.87-94
Published Date 1990/1/1
DOI https://doi.org/10.11477/mf.1406900010
  • Abstract
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The clinical presentation and radilological fea-tures were analyzed in 30 cases of syringomyelia associated with Chiari malformation. None of the patients had spinal dysraphism. The age on admission ranged from 6 to 59 years with a mean of 27 years. Syringomyelia was diagnosed by CT myelography and or MRI from 1982 to 1988. The initial symptoms were skeletal abno-mality (43%) such as scolisis (12 cases) or pes cavus (one case), unilateral pain or numbness (40%) and unilateral motor weakness (17%). Frequently seen signs on admission were sensory deficit (100%), scoliosis (57%), muscle weakness (57%), muscle atrophy (37%) and lower cranialnerve palsy (40%). The neurological findings were asymmetrical in all patients. The characteristic neurological findings in the cases presenting under 20 years of age were unilateral sensory and motor deficits (61%) with decreased or absent deep tendon reflex on the same side. The locali-zation of the syrinx in axial section varied accord-ing to the level even in the same case. In 15 cases with unilateral sensory disturbance or uni-lateral sensory and motor deficit, the syrinx was located in the region corresponding to the pos-terolateral portion on the same side as that of sensory disturbance in the cervical or thoraciclevel. On the other hand, in 15 cases with bila-teral sensory and motor deficit, the syrinx was located in the central portion and extended into the posterolateral portion of the more affected side. The authors think that the syrinx which originates from the unilateral posterolateral por-tion, extends to involve the gray matter around the central canal and the posterolateral portion of the other side with progression of the syrinx to cause bilateral disturbance. As a result, unila-teral neurological symptoms also become bilateral with progression of the syrinx.


Copyright © 1990, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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