By Privat-Dozent Dr. Jörg Klekamp, Professor Madjid Samii (auth.)
Magnetic resonance imaging (MRI) has revolutionized our figuring out of many neurological illnesses. this is often the 1st textbook on syringomyelia through a unmarried crew of authors because the advent of this imaging modality. according to a pathophysiological idea that is awarded within the establishing chapters of this ebook, we offer instructions for analysis and surgical operation of sufferers with syringomyelia. Syringomyelia is a manifestation of cerebrospinal fluid (CSF) movement obstruction, spinal wire tethering, or a spinal twine tumor. as a result, an underlying pathology characterised by way of no less than this type of beneficial properties should be pointed out for each sufferer. each one entity that can bring about syringomyelia is defined in a separate bankruptcy, protecting clincial displays, neuroradiological gains, neurophysiology, surgical symptoms and methods and a close research of postoperative effects. targeted sections are dedicated to sufferers in whom surgery failed initially.This booklet might be useful any doctor facing a sufferer with syringomyelia to start up the ideal diagnostic try out and experiences to spot the underlying sickness. in response to the analyses of postoperative results for every of those problems, the sufferer can be recommended to both endure surgical procedure or to proceed conservative remedy. Neurosurgeons are given detailed guidance for surgical symptoms and techniques. Microsurgical strategies are illustrated step-by-step and contain certain intraoperative photographs.
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Additional resources for Syringomyelia: Diagnosis and Treatment
In Chiari type III malformation (CMIII), herniation of the cerebellum is combined with craniocervical meningoen - cephalocele and aplasia of the tentorium [208, 230] (Fig. 3). Chiari type IV malformation (CMIV) is characterized by hypoplasia or even aplasia of the cerebellar vermis. This malformation is discussed in the chapter section on rhombencephalic malformations (Sect. 2). Chiari himself suspected that these malformations were caused by congenital hydrocephalus in conjunction with a small posterior fossa.
Always associated with CMII are hydrocephalus, due to obstruction of foramina of Magendie and Luschka, and lumbar myelomeningocele. Sometimes additional features can be observed, such as a spina bifida of the upper cervical segments, dysplasia of the brains tern (especially midbrain), agenesis of the corpus callosum, hypoplasia of the tentorium, and bony anomalies of petro us bone and clivus [75, 208). In Chiari type III malformation (CMIII), herniation of the cerebellum is combined with craniocervical meningoen - cephalocele and aplasia of the tentorium [208, 230] (Fig.
Therefore, successful management of patients with syringomyelia requires, foremost, identification and appropriate management of the underlying disorder. If this can be achieved, syringomyelia no longer poses a threatening clinical problem because, at least, further progression of neurological symptoms will be prevented. Outcome and prognosis of patients with syringomyelia are determined primarily by the disease process which has caused the syrinx. In other words, it is not the syringomyelia but the causative pathology that primarily needs treatment.
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