Mousele Christina, Georgiopoulos Miltiadis, Constantoyannis Constantine
a Department of Neurosurgery, University Hospital of Patras, Faculty of Medicine , University of Patras , Patras , Greece.
J Spinal Cord Med. 2019 Mar;42(2):260-264. doi: 10.1080/10790268.2018.1439437. Epub 2018 Feb 27.
Syringobulbia is a very rare progressive disorder of central nervous system, with several possible underlying conditions. Rarely, it is also encountered as a late complication of syringomyelia.
In the present manuscript, a case of a paraplegic patient, due to traumatic spinal cord injury (thoracolumbar fracture), presenting after years progressively developing symptoms of the lower cranial nerves and upper extremities, owed to syringomyelia and syringobulbia, the surgical treatment applied and its outcomes are described. We performed a syringo-peritoneal shunting procedure using a T-tube. The patient's symptoms resolved postoperatively and the cavity's size was reduced to a great degree.
CONCLUSION/CLINICAL RELEVANCE: The late appearance of cranial nerve deficits or symptoms-signs of the upper extremities in a patient with traumatic thoracic spinal cord injury should raise suspicion that post-traumatic syringomyelia or syringobulbia has occurred. In such cases, radiologic evaluation and early surgical drainage of the cyst as a means of preventing significant delayed neurologic deficit is advocated.
延髓空洞症是一种非常罕见的中枢神经系统进行性疾病，有多种潜在病因。很少情况下，它也会作为脊髓空洞症的晚期并发症出现。
在本手稿中，描述了一例因创伤性脊髓损伤（胸腰段骨折）导致截瘫的患者，数年后逐渐出现下颅神经和上肢症状，原因是脊髓空洞症和延髓空洞症，以及所采用的手术治疗及其结果。我们使用T型管进行了脊髓-腹腔分流术。患者术后症状缓解，空洞大小大幅缩小。
结论/临床意义：创伤性胸段脊髓损伤患者出现颅神经缺损或上肢症状体征的延迟出现，应怀疑发生了创伤后脊髓空洞症或延髓空洞症。在这种情况下，提倡进行放射学评估并早期手术引流囊肿，以预防严重的延迟性神经功能缺损。
