Operative Treatments in Syringomyelia Caused by Trauma or Arachnoiditis

OBJECTIVE: Most cases of syringomyelia with arachnoid scarring were related to spinal trauma or inflammatory reaction. The aim of this study is to analyze the influence of arachnoid scarring on the altered dynamics of cerebrospinal fluid(CSF) and determine the proper treatment. METHODS: Between Jan 1991 and Dec 2001, We have operated on 15 patients with progressive neurological deficits associated with syringomyelia. We analyze the clinical presentations, radiographic and magnetic resonance images. RESULTS: As to cause of syringomyelia, 11 patients were related with trauma and 4 patients were tuberculous meningitis. Shunting procedures underwent in 11 patients and 5 showed clinical improvement. Subarachnoid adhesiolysis and expansile duraplasty were performed in 4 patients and 3 experienced clinical improvement. The 6 patients with shunting procedures were neurologically deteriorated and 4 were reoperated. CONCLUSION: The arachnoid scarring interferes with CSF flow and causes syringomyelia. Successful long-term outcome in the surgical treatment of syringomyelia caused by focal arachnoid scar appeared to require microsurgical dissection of scar and expansile duroplasty. For extensive arachnoid scarring over multiple spinal levels or after previous surgery, shunting procedure may be indicated only.

Cervical Intramedullary Cysticercosis: Case Report

Spinal intramedullary cysticercosis is a rare manifestation of neurocysticercosis and may present as a isolated lesion. We report a case of cervical intramedullary cysticercosis in a 57-year-old man. The patient presented with weakness, numbness of the right upper extremity, and urinary difficulty. Magnetic resonance images demonstrated a round cystic lesion at the C4-5 level. We performed C4-5 laminectomy with total removal of intramedullary cystic lesion. Diagnosis was confirmed by histopathological examination. The patient was given albendazole(15mg/kg/day for 30 days) along with corticosteroid.