new : slit like syrinx info by Dr's Batzdorf and Holly

[Guest guest]

http://www.medscape.com/viewarticle/433436

There are also some other reports from this confence at in the article ..I

copied and pasted the syrinx abstract /report below .

Return to 70th Annual Meeting of the American Association of Neurological

Surgeons

Advances in Neurological Surgery Techniques

Slitlike Syrinx Cavities: A Persistent Central Canal

Syringomyelia is a complicated disorder with a multitude of etiologies. These

spinal cord cavitations can be created by cervicomedullary obstruction

secondary to a Chiari malformation, scarring after a spinal trauma,

hydrocephalus, infection, or neoplastic diseases. At the AANS meeting,

Langston T. Holly, MD, and Ulrich Batzdorf, MD,[15] presented data on a

series of 32 cases with a distinct form of spinal cavitation, which they

termed a " slitlike syrinx cavity. " They defined this entity as a cavity with

a consistently thin diameter, lack of pathogenic factors that alter CSF

dynamics, and occurring in an asymptomatic patient.

Between 1992 and 2000, 45 patients were retrospectively identified at the

UCLA Medical Center with the above-mentioned features. Of these, 32 patients

had long-term follow-up and repeat magnetic resonance imaging (MRI) to

document changes in cavity size. The mean patient age was 40 years (16-60

years), and there were 18 men and 14 women. The most common presenting

symptoms were mechanical spinal pain (13 patients) and radicular pain (9

patients). Twelve patients had normal neurologic examinations, and the

remainder had only minimal sensory or motor abnormalities. There was no

evidence of long tract signs in any patient.

The mean syrinx cavity diameter was 2 mm (range 1-5 mm), with an average

length of 3 vertebral levels. The spinal cavities were all symmetric and no

contrast enhancement was observed on follow-up imaging. The mean follow-up

time for changes in clinical condition and repeated MRI were 38 (6-110

months) and 32 months, respectively. Thirty-one patients were managed

nonsurgically and 1 patient was treated surgically. The surgically treated

patient had a C6-7 anterior cervical discectomy and fusion and the cavity did

not change postoperatively. Six patients were determined to have improved

clinically during the follow-up period, 7 were worse, and 19 were unchanged.

None of the cavities changed in size. In 16 patients, further medical work-up

revealed alternative diagnoses that were determined to be the true cause of

the patients' symptoms.

The cavitations likely do not represent true syringomyelia, but rather are

remnants of the central canal detected in a small percentage of adults. The

authors' experience indicates that these cavities are asymptomatic and are

unlikely to change in size. They can be considered an incidental finding and

the authors recommend using the term " persistent central canal " for this

disorder. Other conditions should be considered (and may often be identified)

in the differential diagnosis of such patients.

Discussant P. Elliott, MD, in reviewing the study, complemented the

authors for their work on these " slitlike " spinal cord cavities. He noted

that there is a paucity of information in the literature to aid physicians

with the treatment of these lesions. He agreed that a persistent central

canal is most likely an incidental finding, but stressed the importance of

ruling out other abnormalities such as hindbrain disorders and spinal

neoplasms or infections.