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Increased pulsatile movement of the hindbrain in syringomyelia associated with the Chiari malformation: cine-MRI with presaturation bolus tracking.
- Source :
-
Neuroradiology [Neuroradiology] 1994; Vol. 36 (2), pp. 125-9. - Publication Year :
- 1994
-
Abstract
- Cine-MRI with presaturation bolus tracking was used in patients with syringomyelia associated with a Chiari malformation to study pulsatile movement of the hindbrain, cervical spinal cord, cerebrospinal fluid and the fluid within the syrinx. Nine patients had 13 examinations, 6 preoperative, 3 after syringosubarachnoid shunting and 4 after posterior fossa decompression. Five controls were also examined. Dynamic display of the acquired images demonstrated downward displacement of the presaturation bolus on the cerebellar tonsils and medulla oblongata (or upper cervical cord) at the C1 level in all preoperative examinations and in two patients after syringosubarachnoid shunting but with residual foramen magnum obstruction. Downward displacement of the bolus on the cervical spinal cord was also demonstrated in 7 examinations, but not observed in the controls. Thus, the hind-brain-spinal cord axis showed larger pulsatile movements in patients with foramen magnum obstruction. Based on these observations and a review of the literature, a new theory on the mode of extension of syringomyelia, emphasising the role of increased pulsatile movement of the hind-brain-spinal cord axis is proposed: that the pulsatile movements, together with a one-way valve mechanism in the syrinx cavity act as a "vacuum-pump" to enlarge the syrinx.
- Subjects :
- Adolescent
Adult
Arnold-Chiari Malformation physiopathology
Cerebellum pathology
Cerebellum physiopathology
Child
Female
Humans
Magnetic Resonance Imaging methods
Male
Middle Aged
Motion Pictures
Movement
Rhombencephalon pathology
Spinal Cord pathology
Spinal Cord physiopathology
Syringomyelia physiopathology
Arnold-Chiari Malformation pathology
Cerebellum abnormalities
Cerebrospinal Fluid physiology
Rhombencephalon physiopathology
Syringomyelia pathology
Subjects
Details
- Language :
- English
- ISSN :
- 0028-3940
- Volume :
- 36
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Neuroradiology
- Publication Type :
- Academic Journal
- Accession number :
- 8183451
- Full Text :
- https://doi.org/10.1007/BF00588077