2020, Number 6
<< Back Next >>
Medisur 2020; 18 (6)
Syringomyelia associated with Chiari type I malformation. Case report
García LJI, Sánchez LA, Valladares VM
Language: Spanish
References: 18
Page: 1198-1209
PDF size: 167.62 Kb.
ABSTRACT
Syringomyelia is a cystic cavity of the spinal cord, and is considered a progressive and degenerative condition. There are multiple and varied ways to classify it, based mainly on its origin, or on known production mechanisms. A 27-year-old patient with a four-month history of motor impairment, which began in the upper limbs and continued with clumsy gait, was presented. On physical examination, he presented paretospastic gait, quadriparesis with a predominance of weakness in the upper limbs with respect to the lower ones, as well as crural and left brachial spasticity, with right brachial hypotonia, associated with distal atrophy of both upper limbs and suspended thermal and painful hypoesthesia of the limb upper right. Nuclear magnetic resonance imaging showed a wide syringomyelic cavity in the cervical spine, with descent of the cerebellar tonsils, compatible with type I Chiari malformation. Although the association of both entities is common, progressive motor deficit in a young patient is a reason for admission or consultation rare in the Neurology Service. In these cases, decompressive treatment can decrease the size of the syringomyelic cavity.
REFERENCES
Montalvo JP, Moreira DV. Evolución Natural de la Siringomielia: Presentación de un Caso. Rev Ecuat Neurol. 2017;26(1):72-4.
Stino AM, Lo Ruso SA. Myelopathies Due to Structural Cervical and Thoracic Disease. Continuum (Minneap Minn). 2018;24(2 Suppl Spinal Cord Disorders):567-83.
Arana A, Martínez Ó, Lázaro E, Amayra I, López J, Pérez M, et al. Revisión bibliográfica sobre la sintomatología cognitiva en la malformación de Chiari tipo I. MLS Psychology Research. 2018;1(1):23-40.
Acuña M, González W, Suárez N. Siringomielia como causa de mielopatía. FMC. Formación Médica Continuada en Atención Primaria. 2019;26(2):122-3.
Ghaly RF, Tverdohleb T, Candido KD, Knezevic NN. Management of parturients in active labor with Arnold Chiari malformation, tonsillar herniation, and syringomyelia. Surg Neurol Int. 2017;8:10.
Mestres O. Repercusiones de la malformación de Chiari 1 en la calidad de vida del paciente [Tesis]. Barcelona: Universidad de Barcelona; 2015 [citado 25 Feb 2020]. Disponible en: http://diposit.ub.edu/dspace/bitstream/2445/67777/1/OMiS_TESIS.pdf.
Matos R, Casanova L, Sánchez J, Castellano V. Defectos en la trabeculación del espacio subaracnoideo espinal y su importancia clinico-quirúrgica en la siringomielia. Acta Bioclínica. 2017;8(15):178-202.
Maharaj MM, Phan K, Mobbs R. Spontaneous regression of post-traumatic syringomyelia: a case report and literature review. J Clin Neurosci. 2017;44:249-53.
Vandertop WP. Syringomyelia. Neuropediatrics. 2014;45(1):3-9.
Pillich D, El Refaee E, Mueller JU, Safwat A, Schroeder HW, Baldauf J. Syringomyelia associated with cervical spondylotic myelopathy causing canal stenosis. A rare association. Neurol Neurochir Pol. 2017;51(6):471-75.
Strahle J, Muraszko KM, Garton HJL, Smith B, Starr J, Kapurch JR, et al. Syrinx location and size according to etiology: identification of Chiari-associated syrinx. J Neurosurg Pediatr. 2015;1(1):21-9.
Mehta A, Chilakamarri P, Zubair A, Kuruvilla D, et al. Chiari headache. Curr Pain Headache Rep. 2018;22(7):49.
Struck AF, Carr CM, Shah V, Hesselink JR, Haughton VM. Cervical spinal canal narrowing in idiopathic syringomyelia. Neuroradiology. 2016;58(8):771-5.
Flores D, Morales C, Ladislao A. Siringomielia asociado a Malformación de Chiari tipo I. Rev Cient Cienc Med. 2012;15(2):49-52.
Vega Y, Aparicio FE, Hidalgo M, Carmenate CD, Falcón A, Garcia D. Malformación de la unión cráneo-cervical de Chiari. Presentación de un caso. MEDICIEGO [revista en Internet]. 2016 [citado 19 Sep 2020];22(2):[aprox. 10p]. Disponible en: http://www.revmediciego.sld.cu/index.php/mediciego/article/download/476/982.
Cervantes M, Meisozo AI, Rodríguez LA. Malformación de Arnold Chiari tipo II. MEDICIEGO [revista en Internet]. 2018 [citado 19 Sep 2020]; 24(2). Disponible en: http://www.revmediciego.sld.cu/index.php/mediciego/article/view/775/122.
López R, Nazar C, Sandoval P, Guerrero I, Mellado P, Lacassie HJ. Malformación de Arnold-Chiari tipo I con siringomielia y epilepsia, analgesia neuroaxial en el trabajo de parto. Rev Esp Anestesiol Reanim. 2011;58(9):594-5.
Ruiz I, Cano A. Malformación de Arnold Chiari tipo I: presentación de un caso. Rev Méd Electrón [revista en Internet]. 2010 [citado 12 Feb 2015];32(5):[aprox. 14p]. Disponible en: http://scielo.sld.cu/pdf/rme/v32n5/spu14510.pdf.