Sudo K, Tashiro K, Miyasaka K
Department of Neurology, Hokkaido University School of Medicine, Sapporo, Japan.
Acta Neurol Belg. 1998 Sep;98(3):279-83.
We analysed six patients who showed spontaneous improvement among the 19 nonsurgically treated cases of syringomyelia with low-situated cerebellar tonsils who visited our outpatient clinic. MR images both before and after improvement were available for two of these patients; CT-myelography before improvement and MR images after improvement were used for two patients; and in the remaining two patients, MR images after improvement only were used. Consequently, we were able to abstract several features from detailed and precise neurological and radiological evaluations of these patients. These features consisted of mild (rather than severe) disability, as well as four radiological features--a rounded shape of the lower edge of the cerebellar tonsils, a low tightness of the foramen magnum, an elevation of the tonsils during the course of the disease. Results of our radiological analyses were consistent with the theories proposed for the pathogenesis of syringomyelia in the light of the CSF flow around the foramen magnum. We propose that the features we have isolated are useful in determining treatment policies and prognoses of patients with syringomyelia accompanied by low-situated cerebellar tonsils.
我们分析了19例门诊就诊的低位小脑扁桃体型脊髓空洞症非手术治疗患者中的6例自发改善病例。其中2例患者有改善前后的磁共振成像（MR）图像；2例患者使用改善前的CT脊髓造影和改善后的MR图像；其余2例患者仅使用改善后的MR图像。因此，我们能够从对这些患者详细而精确的神经学和放射学评估中提取出几个特征。这些特征包括轻度（而非重度）残疾，以及四个放射学特征——小脑扁桃体下缘呈圆形、枕大孔狭窄程度低、病程中扁桃体上移。我们的放射学分析结果与根据枕大孔周围脑脊液流动提出的脊髓空洞症发病机制理论一致。我们认为，我们所分离出的这些特征有助于确定伴有低位小脑扁桃体的脊髓空洞症患者的治疗策略和预后。
