Ayuzawa S, Tsukada A, Enomoto T, Yasuda S, Uemura K, Yamada T, Matsumura A, Nose T
Department of Neurosurgery, University of Tsukuba, Ibaraki.
Neurol Med Chir (Tokyo). 1995 Apr;35(4):243-6. doi: 10.2176/nmc.35.243.
A 34-year-old male presented with intrasyringal hemorrhage associated with Chiari type I malformation manifesting as a history of repetitive severe pain around his neck and back and progressive sensory disturbance. Magnetic resonance imaging clearly demonstrated syringomyelia at the cervical region associated with Chiari type I malformation and hemorrhage in the syrinx which was strongly suggestive of bleeding into pre-existing syringomyelia or Gowers' syringal hemorrhage. Irrigation of the syrinx and syringosubarachnoid shunting were performed, but rebleeding occurred causing shunt malfunction. Shunt revision was performed, but a new cavity developed above the original syrinx. Foramen magnum decompression resulted in successful reduction of the new syrinx and subsequent neurological improvement. Simultaneous foramen magnum decompression and syrinx irrigation may be a better approach to treat this disease.
一名34岁男性因与Chiari I型畸形相关的脊髓内出血就诊，表现为颈部和背部反复出现严重疼痛史及进行性感觉障碍。磁共振成像清楚地显示颈椎区域存在与Chiari I型畸形相关的脊髓空洞症以及脊髓空洞内出血，这强烈提示出血进入已存在的脊髓空洞症或Gowers脊髓空洞出血。对脊髓空洞进行了冲洗并实施了脊髓空洞 - 蛛网膜下腔分流术，但发生了再出血导致分流装置失灵。进行了分流装置修复，但在原脊髓空洞上方出现了一个新的空洞。枕骨大孔减压术成功使新的脊髓空洞缩小并随后神经功能得到改善。同时进行枕骨大孔减压术和脊髓空洞冲洗可能是治疗这种疾病的更好方法。
