Definitions Definitions syringomyelia login to view 1 more bullet syringobulbia login to view 1 more bullet Epidemiology Synringomyelia incidence login to view 1 more bullet demographic login to view 2 more bullets Etiology Pathophysiology usually result from lesions that partially obstruct CSF flow including login to view 10 more bullets Associated conditions developmental scoliosis login to view 2 more bullets Klippel-Feil deformity Charcot's joints login to view 2 more bullets Presentation Syringomyelia symptoms login to view 7 more bullets physical exam login to view 14 more bullets Syringobulbia symptoms related to cranial nerve involvment login to view 4 more bullets Imaging Radiographs relative lack of apical lordosis may indicate presence of syrinx scoliosis series for evaluation of scoliosis CT not applicable for characterization of syrinx, only for associated scoliosis MRI diagnosis of syrinx made by MRI obtain MRI with gadolinium enhancement to rule out associated tumor indications for MRI in patients with scoliosis login to view 5 more bullets Histopathology Gross pathology cavitation of spinal cord gray matter syrinx in continuity with or adjacent to central canal inner layer of gliotic tissue Differential Diagnosis Hydromyelia Glioependymal cysts Myelomalacia Cystic tumors Persistent central canal Treatment Nonoperative observation login to view 3 more bullets Operative decompression of the foramen magnum and upper cervical cord +/- shunting login to view 11 more bullets spinal fusion login to view 5 more bullets Complications In general, same as for idiopathic scoliosis Increased risk of neurologic deterioration including paralysis if fusion done with undiagnosed syrinx Prognosis Natural history not well defined prognosis depends on degree of spinal deformity and neurologic deficits multiple authors report resolution or improvement in syrinx size and neurologic deficits