Syringomyelia or Hydromyelia

Syringomyelia is a condition in which cerebrospinal fluid accumulates within the spinal cord. In fact, hydromyelia means water in the spinal cord. The accumulation of cerebrospinal fluid is called the syrinx. The syrinx can enlarge, eventually causing damage to the substance of the spinal cord.

Signs & Symptoms

Symptoms of syringomyelia include numbness and decreased sensitivity to pain, heat, and cold in the arms, hands, shoulders, and upper back. Patients also experience weakness with wasting of the muscles of the hands and arms, weakness of the legs, impaired balance. They may experience pain in the neck and arms, often burning in nature and exacerbated or worsened by coughing, sneezing or straining. They can develop difficulty with bladder control.

Testing & Diagnosis

Magnetic resonance imaging or MRI is the best method for detecting a syrinx.

Treatment

There are several treatment options for syringomyelia. Treatment is based on the severity of the patient's condition and the cause of the syrinx. If the syrinx occurs in conjunction with a Chiari malformation, the only treatment that is usually required is the direct treatment of the Chiari malformation itself. The syrinx then usually resolves on its own once the spinal fluid circulation is normalized. In other cases, the syrinx may be drained directly using a tube or a shunt. A syrinx associated with a tumor is treated in conjunction with the removal of the tumor. A patient who has a syrinx and elects not to undergo treatment should be followed closely using MRI scan to ensure that the syrinx does not expand. A patient should also be examined at least twice per year to make sure that there is no decline in neurological functioning, such as increasing numbness, decreased strength, increased wasting of the muscles. Progressive problems should encourage the patient to seek medical treatment before the problem becomes irreversible.

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