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Thread: Spinal Cord Central Canal Fusiform Syrinx

  1. #1

    Spinal Cord Central Canal Fusiform Syrinx

    I am a person that has been diagnosed with a centralfusiform syrinx running down the dead center of my thoracic spinal cord and Ihave the following questions:
    1) Doesevery grown adult have a central canal located in the center of their spinalcord that is open from lower lumbar region and up to brain ?

    2) Isthe central canal of an adult always filled with CSF, cerebrospinal fluid ?

    3) Whatcould cause CSF fluid to get trapped or closed off inside the central canal ?

    4) OnMRI Imaging, why am I seeing that light colored streak running verticaly downthe center of my spinal cord ?

    5) Canyou have a syrinx that is located completely outside of the central canal? Will syrinxes inside the central canalproduce different symptoms than syrinxes located outside the central canal ?

    6) Doesanybody really know why syrinxes are known to cause severe headaches ? Are the severe headaches caused by CSF fluidbuildup pressure in the brain or head ?

    Any insight on the answers to these questions isgreatly appreciated. Thanks,
    Ken Trinkaus

  2. #2
    I have asked Dr. Young to respond to your questions when he has the time.

    (KLD)

  3. #3
    KLD,
    Ok, I will wait and see if Doctor Young can answer some of my spinal cord central canal questions.
    Ken Trinkaus

  4. #4
    My answers are embedded. I hope they are helpful.

    Quote Originally Posted by kbtrink
    I am a person that has been diagnosed with a centralfusiform syrinx running down the dead center of my thoracic spinal cord and I have the following questions:

    1) Does every grown adult have a central canal located in the center of their spinal cord that is open from lower lumbar region and up to brain ?
    Yes, the central canal normally runs from the fourth ventricle in the brain stem all the way to the lumbosacral spinal cord

    2) Is the central canal of an adult always filled with CSF, cerebrospinal fluid ?
    [Color=#FF3366] Yes, the central canal should be filled with cerebrospinal fluid [/red]

    3) What could cause CSF fluid to get trapped or closed off inside the central canal?
    Most CSF are produced in the fourth ventricle in the brainstem and flow up to the brain and down the spinal cord in the subarachnoid space. After spinal cord injury, inflammation or infection may cause the arachnoid membrane to stick to the spinal cord pial surface. The dogma is that these adhesions obstruct CSF flow down the spinal cord. When that happens, some of the CSF is shunted to flow in the central canal and this leads to enlargement of the central canal and the formation of syringomyelia. There is much misunderstanding of what a syringomyelic cyst is. In my opinion, that term should be reserved for an enlargement of the central canal. It should not be used to refer to the formation of a cavity in the spinal cord that is not surrounded by ependymal cells (the cells that line the central canal). For many years, surgeons thought that the enlargement of the central canal is due to pressure. However, many MRI studies have shown that the fluid in the central canal is flowing (albeit slowly) and this argues against pressure as the cause of the canal enlargement. Since the mid-1990?s, the concept that syringomyelia is due to shunting of flow into the central canal has become popular and has led to the increasing use of untethering and removal of arachnoid adhesions as the treatment of syringomyelic cysts, as opposed to the traditional use of a shunt by putting tubes into the syringomyelic cyst. There was a neurosurgeon who developed a ?piccolo technique? of punching holes into the cyst with a laser in the hopes of decompression it. The shunts don?t work most of the time and almost always occlude. Untethering surgery, however, seems to help many people and so, most surgeons today shunt and untether at the same time.


    4) On MRI Imaging, why am I seeing that light colored streak running verticaly downthe center of my spinal cord ?
    The reason the cyst is light colored is because it is filled with water (CSF) and water gives off the greatest magnetic resonance signal.

    5) Can you have a syrinx that is located completely outside of the central canal? Will syrinxes inside the central canalproduce different symptoms than syrinxes located outside the central canal ?
    You can have cysts that are outside the central canal. These are usually (and in my opinion, should not be) called syringomyelic cysts. They can be subarachnoid cysts or just cysts.

    6) Does anybody really know why syrinxes are known to cause severe headaches? Are the severe headaches caused by CSF fluid buildup pressure in the brain or head ?
    I have always thought that the reason why people who have syringomyelic cysts have severe headaches is obstruction of cerebrospinal fluid flow, which causes both the headaches and the syringomyelic cyst.

    Any insight on the answers to these questions is greatly appreciated. Thanks,

    Ken Trinkaus
    Last edited by Wise Young; 10-17-2014 at 05:00 PM.

  5. #5
    Doctor Wise Young,

    Ok, thanks for answering my six questions. Let me digest your answers as I am fairly new to this area of medical research and treatment. I am sure I will have some follow up questions but too tired right now to create meaningfull questions. Take care,

    Ken

  6. #6
    DearDoctor Wise Young,
    There is a follow up question that I have right nowregarding my central fusiform syrinx: Ifeverybody has a central canal in the center of their spinal cord that is alwaysfilled with CSF cerebrospinal fluid, then why would not everybody’s MRI imagingpicture of their spinal cord in vertical view show that light colored streakrunning down the center of their spinal cord in up and down direction basically? What is different in my spinal cordthat is causing that light colored streak to show up in imaging pictures invertical up and down view ? Is it truethat in most normal people, you would never see that light colored streakrunning vertically up and down in MRI imaging pictures ? Perhaps this is a radiology question but alsoan anatomy question on how my syrinx or hydromyelia shows up as that lightcolored vertical streak. Any insight to helpme further understand this would be appreciated.
    Sincerely,
    Ken Trinkaus

  7. #7
    kbtrink, was your MRI evaluated by an expert neuroradiologist? If not, I would be asking for that to occur, perhaps as part of a second opinion. There is some individual variation within the norms of how the central canal shows up on MRIs.

    (KLD)

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