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Sudden Exacerbation in Atypical Syringomyelia with a Unilateral Superficial Sensory Diasorders as the Principal Manifestation Toshiaki Shiojiri 1,2 , Kuniaki Tsuchiya 1 , Sadakiyo Watahiki 1 1Department of Neurology, Musashino Red Cross Hospital Keyword: syringomyelia , sudden exacerbation , Chiari malformation , MRI , CSF pulsation pp.1075-1078
Published Date 1993/11/1
DOI https://doi.org/10.11477/mf.1406900563
  • Abstract
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We report a 22 year-old woman with syrin-gomyelia, who complained of a sudden abnormal sensation in the left neck and upper extremity after maintaining her neck in flexion for sometime. Neurologic examination revealed superficialhypesthesia on the left from C2 down, but normal motor function. The mode of onset in our patient was atypical. The clinical manifestations of syrin-gomyelia are usually slowly progressive. On the basis of X-P film of the cervical spine and cranial MRI, a diagnosis of syringomyelia with Chiari malformation (type 1) was made. The syrinx cav-ity extended from Cl to L1. On the transaxial image of the cervical cord, the syrinx cavity was demonstrated in the posterior horn area ipsilateral to the sensory disturbance. The CSF flow-void sign was present in the syrinx cavity, probably reflecting pulsation of the syrinx fluid. An abnormally high signal intensity area adjacent to the syrinx cavity on T2-weighted sequences indicated damaged cord. We speculate that dynamic factors produced by neck flexion and fluid pulsation explain the sudden excerbation in our patient.


Copyright © 1993, 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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