Presentation
Decreased sensation of pain and temperature in both hands and medial aspects of the forearms as well as mild motor weakness and wasting of the thenar muscles.
Patient Data
Prominent central spinal canal with fluid equivalent signal involving a long segment of the spinal cord starting opposite C2/3 disc and extending caudally along the dorsal cord.
Mild platybasia is also suggested.
Moderate cervical spondylo-degenerative changes with multilevel mild disc lesions.
Case Discussion
An accumulation of cerebrospinal fluid (CSF) may lead to simple distention of the central canal of the spinal cord; in such cases, the cavity is lined by ependymal cells (hydromyelia). Additionally, an accumulation of CSF may dissect into the surrounding white matter to form a paracentral cavity, in which case, none of the cavities are lined by ependyma (syringomyelia). In many instances, both hydromyelia and syringomyelia are coexisting (syringohydromyelia). The syringomyelic cavity expands and compresses the hydromyelic cavity, and the communication between the two cavities may atrophy and be lost. Hydromyelia and syringomyelia may be difficult to distinguish even after a detailed histologic examination.