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An international workshop entitled ``Research Priorities for Syringomyelia,'' sponsored by the National Institute of Neurological Disorders and Stroke (NINDS), of the National Institutes of Health (NIH), was held in Chantilly, Virginia, June 20 and 21, 1994. This workshop brought together a group of basic and clinical investigators to discuss the current clinical understanding and management of syringomyelia, recent technical advances, and future research priorities. Ann Charnley, representing the American Syringomyelia Alliance Project, and Richard Grant, from the Paralyzed Veterans of American, made presentations in which they discussed patient perspectives on syringomyelia.
The workshop focused on the following topics: pathology, CSF dynamics and pathophysiology, and clinical management of congenital and acquired syringomyelia. Panel discussions followed each topic, and priorities for future research objectives were formulated at the final session.
Background.
Syringomyelia is a disorder characterized by an abnormal fluid-filled cyst (syrinx) in the spinal cord, which causes progressive neurologic symptoms as it expands Syringomyelia may be congenital or acquired. It most commonly occurs in the cervical segments of the spinal cord but can involve the entire length of the spinal cord and occasionally extends into the brainstem (syringobulbia). Most cases considered to be congenital present in adulthood and are associated with hindbrain herniation (Chiari type I). Infantile forms are associated with the more severe Chiari types II and III abnormalities.
Posttraumatic spinal cord cavitation is a progressive disorder in which initial spinal cord damage leads to altered CSF hydrodynamics and arachnoiditis, resulting in progressive expansion and extension of the syrinx. Syringomyelia may also occur after intradural spinal surgery, such as resection of a spinal cord tumor. Postinflammatory syringomyelia, which may result from infections (e.g., tubercular, fungal, parasitic) or from chemical meningitis, is commonly associated with arachnoidal scarring.
To understand the underlying causes of syringomyelia, it is necessary to understand the structure and …
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