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Anatomical basis of syringomyelia occurring with hindbrain lesions.
Neurosurgery. 1993 May; 32(5):748-54; discussion 754.N

Abstract

Hindbrain lesions that distort or compress the cervicomedullary junction are commonly associated with syringomyelia. As a basis for discussing pathogenetic mechanisms, the upper end of the central canal of the spinal cord was examined histologically in six aborted fetuses and 14 adults dying of natural causes; the results were correlated with magnetic resonance images in 40 normal subjects. The central canal of the medulla, which extends from the cervicomedullary junction to the fourth ventricle, was found to migrate dorsally, elongate in dorsoventral diameter, and dilate beneath the tip of the obex to form a large, everted aperture. This opening communicates directly with the subarachnoid space through the foramen of Magendie and is indirectly continuous with the main body of the fourth ventricle. In adults, the aperture of the central canal is located approximately 1.0 cm below the tela choroidea inferior and 3.5 cm below the midpoint of the fourth ventricle. Analysis of magnetic resonance imaging scans in 45 patients with syringomyelia and simple hindbrain lesions revealed two patterns of cavity formation: 1) lesions that obstructed the upper end of the central canal or its continuity with the subarachnoid space produced a noncommunicating type of syringomyelia; and 2) lesions that obstructed the basilar cisterns or the foraminal outlets of the fourth ventricle produced a communicating type of syringomyelia (hydromyelia) in association with hydrocephalus. Evidence is presented that syrinxes occurring with hindbrain lesions are not caused by a caudal flow of cerebrospinal fluid from the fourth ventricle into the central canal of the spinal cord.

Authors+Show Affiliations

Department of Neurosurgery, State University of New York Health Science Center, Brooklyn.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8492850

Citation

Milhorat, T H., et al. "Anatomical Basis of Syringomyelia Occurring With Hindbrain Lesions." Neurosurgery, vol. 32, no. 5, 1993, pp. 748-54; discussion 754.
Milhorat TH, Miller JI, Johnson WD, et al. Anatomical basis of syringomyelia occurring with hindbrain lesions. Neurosurgery. 1993;32(5):748-54; discussion 754.
Milhorat, T. H., Miller, J. I., Johnson, W. D., Adler, D. E., & Heger, I. M. (1993). Anatomical basis of syringomyelia occurring with hindbrain lesions. Neurosurgery, 32(5), 748-54; discussion 754.
Milhorat TH, et al. Anatomical Basis of Syringomyelia Occurring With Hindbrain Lesions. Neurosurgery. 1993;32(5):748-54; discussion 754. PubMed PMID: 8492850.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anatomical basis of syringomyelia occurring with hindbrain lesions. AU - Milhorat,T H, AU - Miller,J I, AU - Johnson,W D, AU - Adler,D E, AU - Heger,I M, PY - 1993/5/1/pubmed PY - 1993/5/1/medline PY - 1993/5/1/entrez SP - 748-54; discussion 754 JF - Neurosurgery JO - Neurosurgery VL - 32 IS - 5 N2 - Hindbrain lesions that distort or compress the cervicomedullary junction are commonly associated with syringomyelia. As a basis for discussing pathogenetic mechanisms, the upper end of the central canal of the spinal cord was examined histologically in six aborted fetuses and 14 adults dying of natural causes; the results were correlated with magnetic resonance images in 40 normal subjects. The central canal of the medulla, which extends from the cervicomedullary junction to the fourth ventricle, was found to migrate dorsally, elongate in dorsoventral diameter, and dilate beneath the tip of the obex to form a large, everted aperture. This opening communicates directly with the subarachnoid space through the foramen of Magendie and is indirectly continuous with the main body of the fourth ventricle. In adults, the aperture of the central canal is located approximately 1.0 cm below the tela choroidea inferior and 3.5 cm below the midpoint of the fourth ventricle. Analysis of magnetic resonance imaging scans in 45 patients with syringomyelia and simple hindbrain lesions revealed two patterns of cavity formation: 1) lesions that obstructed the upper end of the central canal or its continuity with the subarachnoid space produced a noncommunicating type of syringomyelia; and 2) lesions that obstructed the basilar cisterns or the foraminal outlets of the fourth ventricle produced a communicating type of syringomyelia (hydromyelia) in association with hydrocephalus. Evidence is presented that syrinxes occurring with hindbrain lesions are not caused by a caudal flow of cerebrospinal fluid from the fourth ventricle into the central canal of the spinal cord. SN - 0148-396X UR - https://www.unboundmedicine.com/medline/citation/8492850/Anatomical_basis_of_syringomyelia_occurring_with_hindbrain_lesions_ L2 - https://academic.oup.com/neurosurgery/article-lookup/doi/10.1227/00006123-199305000-00008 DB - PRIME DP - Unbound Medicine ER -