Communicating Syringomyelia

Abstract

Background: Communicating syringomyelia can develop in association with hydrocephalus, with communication between syringomyelia and the fourth ventricle a representative neuroimaging finding.

Case description: A 51-year-old woman presented with slowly progressive bladder dysfunction and scoliosis. She had a nonfunctioning cerebrospinal fluid shunt that had been placed after birth for neonatal hydrocephalus. Tetraventricular enlargement and a holocord syrinx were noted in neuroimaging findings, while phase contrast magnetic resonance imaging and ventriculography revealed communication between the syrinx and fourth ventricle via a dilated central canal. Placement of a de novo ventriculoperitoneal shunt led to collapse of the syringomyelia, though apparent improvement of clinical symptoms was not obtained.

Conclusions: Communicating syringomyelia can develop as a late complication in patients with shunted hydrocephalus. In the majority of reported cases, shunt revision has been shown to be effective, though some cases require posterior fossa decompression and exploration.

Keywords: Communicating syringomyelia; Hydrocephalus; Shunt malfunction; Syringomyelia; Ventriculoperitoneal shunt.