Acta Neurochirurgica

, Volume 137, Issue 1–2, pp 38–43 | Cite as

Syringomyelia in association with tumours of the posterior fossa

Pathophysiological considerations, based on observations on three related cases
  • J. Klekamp
  • M. Samii
  • M. Tatagiba
  • A. Sepehrnia
Clinical Articles


In this report we describe 3 patients with syringomyelia in association with tumours of the posterior fossa. In each patient the syrinx was demonstrated on pre-operative magnetic resonance imaging (MRI). After total or partial removal of the tumour the syrinx collapsed. It is concluded that the pathogenesis of syrinx formation in this entity requires interference with normal cerebrospinal fluid (CSF) flow at the foramen magnum. We suggest that the obstruction to the flow of CSF causes alterations in the passage of extracellular fluid (ECF) in the spinal cord which lead to syringomyelia.


Hindbrain hernia syringomyelia cerebrospinal fluid extracellular fluid 


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  1. 1.
    Abbe R, Coley WB (1892) Syringomyelia; operation, exploration of the cord; withdrawal of fluid. J Nerv Ment Dis 19: 512–520Google Scholar
  2. 2.
    Aboulker J (1979) La syringomyelie et les liquides intrarachidiens. Neurochirurgie 25 [Suppl]: 1–144Google Scholar
  3. 3.
    Armonda RA, Citrin CM, Foley KT, Ellenbogen RG (1994) Quantitative cine-mode magnetic resonance imaging of Chiari I malformations: an analysis of cerebrospinal fluid dynamics. Neurosurgery 35: 214–224Google Scholar
  4. 4.
    Ball MJ, Dayan AD (1972) Pathogenesis of syringomyelia. Lancet 2: 799–801Google Scholar
  5. 5.
    Banna M (1988) Syringomyelia in association with posterior fossa cysts. AJNR 9: 867–873Google Scholar
  6. 6.
    Bidzinski J (1988) Pathological findings in suboccipital decompression in 63 patients with syringomyelia. Acta Neurochir (Wien) [Suppl] 43: 26–28Google Scholar
  7. 7.
    Budrewicz S, Paradowski B, Podemskij R, Betlej M (1994) Multiple intracranial meningiomas in a patient with asymptomatic syringomyelia. Neurol Neurochir Pol 28: 251–256Google Scholar
  8. 8.
    Cano G, Anderson M, Kutschbach P, Borden J, Saris S (1993) Hydromyelia associated with a posterior fossa cyst. Surg Neurol 40: 512–515Google Scholar
  9. 9.
    Castellano F, Ruggiero G (1953) Meningiomas of the posterior fossa. Acta Radiol 104: 1–157Google Scholar
  10. 10.
    Cserr HF, Cooper DN, Milhorat TH (1977) Flow of cerebral interstitial fluid as indicated by the removal of extracellular markers from rat caudate nucleus. In: Bito LZ, Davson H, Fenstermacher JD (eds) The ocular and cerebrospinal fluids. Exp Eye Res [Suppl] 25: 461–473Google Scholar
  11. 11.
    Dubois PJ, Drayer BP, Sage M, Osborne D, Heinz ER (1981) Intramedullary penetrance of metrizamide in the dog spinal cord. AJNR 2: 313–317Google Scholar
  12. 12.
    Ellertson AB, Greitz T (1970) The distending force in the production of communicating syringomyelia. Lancet 1: 1234Google Scholar
  13. 13.
    Enzmann DR, Pelc NJ (1991) Normal flow patterns with phase-contrast cine MRI imaging. Radiology 178: 467–474Google Scholar
  14. 14.
    Feigin I, Ogata J, Budzilovich G (1971) Syringomyelia: the role of edema in its pathogenesis. J Neuropathol Exp Neurol 30: 216–232Google Scholar
  15. 15.
    Firsching R, Sanker P (1993) MRI follow-up in syringomyelia. Observations from twelve cases. Acta Neurochir (Wien) 123: 206–207Google Scholar
  16. 16.
    Fukui K, Kito A, Iguchi I (1993) Asymptomatic syringomyelia associated with cerebellopontine angle meningioma-case report. Neurol Med Chir 33: 833–835Google Scholar
  17. 17.
    Gardner WJ, Angel J (1958) The cause of syringomyelia and its surgical treatment. Cleve Clin Q 25: 4–8Google Scholar
  18. 18.
    Greitz D (1993) Cerebrospinal fluid circulation and associated intracranial dynamics. A radiologie investigation using MR imaging and radionuclide cisternography. Acta Radiol [Suppl] 386: 1–23Google Scholar
  19. 19.
    Hinokuma K, Ohama E, Oyanagi K, Kakita A, Kawai K, Ikuta F (1992) Syringomyelia. A neuropathological study of 18 autopsy cases. Acta Pathol Japonica 42: 25–34Google Scholar
  20. 20.
    Hutchings M, Weller RO (1986) Anatomical relationships of the pia mater to cerebral blood vessels in man. J Neurosurg 65: 316–325Google Scholar
  21. 21.
    Ikata T, Masaki K, Kashiwaguchi S (1988) Clinical and experimental studies on permeability of tracers in normal spinal cord and syringomyelia. Spine 13: 737–741Google Scholar
  22. 22.
    Kasantikul V, Netsky MG, James AE (1979) Relation of age and cerebral ventricle size to central canal in man. Morphological analysis. J Neurosurg 51: 85–93Google Scholar
  23. 23.
    Kosary IZ, Braham J, Shaked I, Tadmor R (1969) Cervical syringomyelia associated with occipital meningioma. Neurology 19: 1127–1130Google Scholar
  24. 24.
    Kumar C, Panagapoulos K, Kalbag RM, McAllister V (1987) Cerebellar astrocytoma presenting as a syringomyelic syndrome. Surg Neurol 27: 187–190Google Scholar
  25. 25.
    Li KC, Chui MC (1987) Conventional and CT metrizamide myelography in Arnold-Chiari I malformation and syringomyelia. AJNR 8: 11–17Google Scholar
  26. 26.
    McLaurin RL, Bailey OT, Schurr PH, Ingraham FD (1954) Myelomalacia and multiple cavitations of spinal cord secondary to adhesive arachnoiditis. Arch Pathol 57: 138–146Google Scholar
  27. 27.
    Modrego Pardo PJ, Lopez del Val J, Morales Asin F (1990) Syringomyelia, posterior fossa cyst and acute respiratory distress. Neurologia 5: 336–337Google Scholar
  28. 28.
    Newman PK, Terenty TR, Foster JB (1981) Some observations on the pathogenesis of syringomyelia. J Neurol Neurosurg Psychiatry 44: 964–969Google Scholar
  29. 29.
    Oldfield EH, Muraszko K, Shawker TH, Patronas NJ (1994) Pathophysiology of syringomyelia associated with Chiari I malformation of the cerebellar tonsils. Implications for diagnosis and treatment. J Neurosurg 80: 3–15Google Scholar
  30. 30.
    Quencer RM, Post MJD, Hinks RS (1990) Cine MRI in the evaluation of normal and abnormal CSF flow: intracranial and intraspinal studies. Neuroradiology 32: 371–391Google Scholar
  31. 31.
    Rennels ML, Gregory TF, Blaumanis OR, Fujimoto K, Grady PA (1985) Evidence for a ‘paravascular’ fluid circulation in the mammalian central nervous system, provided by the rapid distribution of tracer protein throughout the brain from the subarachnoid space. Brain Res 326: 47–63Google Scholar
  32. 32.
    Shapiro WR (1988) Cerebrospinal fluid circulation and the blood brain barrier. Ann NY Acad Sci 531: 9–14Google Scholar
  33. 33.
    Sherman JL, Citrin CM, Bowen BJ, Gangarosa RE (1986) MR demonstration of Cerebrospinal fluid flow by obstructive lesions. AJNR 7: 571–579Google Scholar
  34. 34.
    Stein BM, Leeds NE, Taveras JM, Pool JL (1963) Meningiomas of the foramen magnum. J Neurosurg 20: 740–751Google Scholar
  35. 35.
    Terae S, Miyasaka K, Abe H, Abe S, Tashiro K (1994) Increased pulsatile movement of the hindbrain in syringomyelia associated with the Chiari I malformation: cine-MRI with presaturation bolus tracking. Neuroradiology 36: 125–129Google Scholar
  36. 36.
    Urasaki E, Soejima T, Yokota A, Matsuoka S (1989) Association of asymptomatic syringomyelia with tentorial meningioma. No Shinkei Geka 17: 985–989Google Scholar
  37. 37.
    Ventureyra ECG, Higgins MJ (1994) Syringomyelia and the Chiari type I malformation: new pathophysiological concepts. Crit Rev Neurosurg 4: 275–285Google Scholar
  38. 38.
    Williams B (1986) Progress in syringomyelia. Neurol Res 8: 130–145Google Scholar
  39. 39.
    Williams B (1993) Surgery for hindbrain related syringomyelia. Adv Tech Stand Neurosurg 20: 107–164Google Scholar
  40. 40.
    Winkler SS, Sackett JF (1980) Explanation of metrizamide brain penetration: a review. J Comput Assist Tomogr 4: 191–193Google Scholar

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • J. Klekamp
    • 1
  • M. Samii
    • 1
  • M. Tatagiba
    • 1
  • A. Sepehrnia
    • 1
  1. 1.Neurosurgical ClinicMedical School of Hannover, Nordstadt HospitalHannoverFederal Republic of Germany

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