The prevalence of symptomatic syringomyelia in patients with chronic spinal cord injury (SCI) is around 4.5%. It is an important cause of treatable neurologic deterioration, although surgical shunting of the syrinx or arachnoid adhesiolysis of tethered elements have unpredictable results. Classically, syrinx extension causes progressive neuropathic pain, often with dissociated sensory loss due ...

BACKGROUND The Chiari Malformation I (CMI) is a disorder of uncertain origin that has been traditionally defined as downward herniation of the cerebellar tonsils through the foramen magnum. The anomaly is a leading cause of syringomyelia and occurs inassociation with osseus abnormalities at the craniovertebral junction. In contrast to other Chiari malformations, CMI tends to present in the seco...

Background: Despite several hypotheses, our understanding of syringomyelia’s pathophysiology remains limited. The hypothesis proposed by Oldfield et al. suggests that piston-like movement the cerebellar tonsils propels cerebrospinal fluid (CSF) into syrinx via spinal perivascular space. However, a significant question unanswered: how does CSF enter and stay in syrinx...

A 21-year-old paraplegic man was seen due to hyperhidrosis and pain in his upper limbs (worse with head extension) for the last few weeks. He stated that the pain was associated with tingling and numbness, and worsened over time. In his medical history, he had a complete T4 level of spinal cord injury (SCI) caused by a fall from height 5 months ago. Physical examination revealed spasticity, wea...

OBJECT Although the traditional nomenclature used to describe hindbrain hernias is useful, there are certainly patients in whom these morphological entities do not strictly apply. One such group is composed of patients with the more recently described Chiari 1.5 malformation in which a Chiari I malformation is seen in combination with brain-stem herniation through the foramen magnum. In an atte...