Ver el código de «Syringomyelia»

==Background==
[[File:Dermatoms alt.png|thumb|Sensory dermatome by spinal level.]]
*Fluid filled cyst (syrinx) within the spinal cord which can expand or elongate over time, destroying surrounding spinal cord tissue.
*Can be due to dilation of the neural tissue surrounding the central canal itself (which can lead to obstructive [[hydrocephalus]]), or it can arise from within the parenchyma of the spinal cord. 
*Typically occurs in the C2 and T9 distribution.
*Most commonly occurs in patients with a pre-existing Chiari malformation.
*Usually seen in young adults
*Most commonly insidious in onset but the effects of the cyst may manifest suddenly after coughing or sneezing

===Types===
*Congenital
**Secondary to Arnold Chiari malformation 
**Associated with [[hydrocephalus]]
*Acquired
**Secondary to an insult to the brain or spinal cord
**Examples: [[stroke]], [[trauma]], [[meningitis]], hemorrhage, or tumor

==Clinical Features==
*Insidious onset
*"Cape-like" distribution of:
**[[Weakness|Paralysis]]
**[[Paresthesia]]
**Pain
*Stiffness of the back, shoulders, and extremities
*Loss of ability to sense extreme hot or cold in the hands
*Proprioception and vibration- spared due to sparing of the dorsal column and medial lemniscus

==Differential Diagnosis==
*[[Brain tumor]]
*[[Guillain-Barré Syndrome]]
*Acute myelopathy
*Brain [[stroke]]
*Spinal cord [[stroke]]
*[[Central pontine myelinolysis]]
*Pediatric ependymoma
*[[Diabetic neuropathy]]
*[[Multiple Sclerosis]]
*[[Transverse Myelitis]]
*[[Myasthenia Gravis]]

==Evaluation==
[[File:Syringomyelia (with arrow).png|thumb|An idiopathic syrinx on MRI.]]
*Imaging
**[[head CT|CT]] to rule out [[intracranial mass|mass]], [[ICH|bleed]], and [[hydrocephalus]]
**[[brain MRI|MRI brain]] and spine will make the diagnosis though this may not be indicated in the ED setting

==Management==
*Ensure no respiratory involvement and consider intubation if severe
*[[Analgesia]]

==Disposition==
*Assuming pain is controlled and no concern for respiratory compromise, discharge home.
*Neurology follow-up- to create and monitor pain management plan
*Neurosurgery- for potential surgical resection

==See Also==
*[[Epidural compression syndromes]]

==External Links==


==References==
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[[Category:Neurology]]