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Thread: syrinx and tethered cord?

  1. #1

    syrinx and tethered cord?

    Hi,

    I would be really grateful for any advice or any information. Apologies for the long post. 3 months ago I had an accident playing soccer. I made a sliding challenge and someone went into my right side and their knee went into my face. I was quite groggy but shook it off and played for another hour. I felt sore for the rest of the day but was largely ok. I then started to spit blood the next day and naturally I was worried. I went to hospital and then gave me a ct scan of my head which was all clear. They told me that I had bleeding in my ear canal and that it would drain in a few days, which it did. In the meantime my neck was getting stiffer and stiffer and I had 3 weeks of stiffness but with help of my physio I was pain free after 3 weeks. Shortly afterwards, however, I started having a strange feeling in my left chest that felt like like a clogged feeling that would radiate to my arm. Wasn't severe but enough to warrant a trip to the DR after it hadn't cleared up after a week. She took my blood pressure and reassured everything was fine. I mentioned it to my physio and he thought it was a trapped nerve due to shortening of my ribs. He tried to increase the space between my ribs and that helped a tiny bit. However then I started to experience pain in my left shoulder and all around my shoulder blade. The pain would come and go but would sometimes feel like my left arm was swollen. After feeling around I noticed that there was muscle thickening in my left pec and on the outside of my shoulder blade by my armpit. I also would have intermittent feeling of tingling in my left arm along with what felt like poor circulation in the arm. My left hand was also getting stiffer and weaker.

    This continued for 6 weeks and finally I went to a shoulder specialist. They checked my shoulder and he didn't see anything wrong but sent me for an MRI of my shoulder and cervical spine. The shoulder mri came back clear but the cervical mri showed a tiny syrinx. I was going on holiday for a week but he suggested I see a neck specialist on my return. I didn't really think much about the syrinx because he sounded so blase about it. I didn't really enjoy my holiday due to the arm and shoulder discomfort.

    Upon my return 3 weeks ago I arranged to see two neurosurgeons. At the same time I was interested by what this syrinx was so starting doing some research. Naturally it wasn't the most comforting reading. Since then I have started to have a whole range of new symptoms that include new neck stiffness, weakness in legs and no energy just to mention a few. Over the last week I have also experienced muscle twitching all over. My arm and hand have progressively got weaker to the point where there is noticeable atrophy. The thickening around my shoulder is still there and despite taking anti inflammatory pills for over 3 weeks nothing bar putting ice on seems to numb the pain. I have barely no strength left in my arm, it tires so easily and this typing alone has caused it to seize up multiple times.

    At the suggestion of my shoulder specialist I had neurophysiological studies done. This showed that nerve conduction studies are normal but
    Left trapezius c4 - No significant abnormality.
    Left deltoid c5 - minor neuropathic changes only.
    Left brachioradialis c6 - mild chronir denervation.
    Left triceps c7 - mild chronic denervation.

    The findings thus provide evidence of mild left c5-c7 radiculopathy, mainly affecting c6-c7. There is no acute or ongoing denervation.

    Both neurosurgeons have said that it is a dilated central canal and not syringomaelia. One asked for an mri with contrast to rule out a tumour, which it did. Both said there is no chiari. They offered no explanation for my symptoms and due to worsening symptoms I went to see a 3rd neurosurgeon and two neurologists. The two neurologists saw no neurological symptoms and have prescribed medication. The 3rd neurosurgeon was not concerned by the syrinx but wanted me to have a brain mri along with a thoracic and lumbar mri. This was last week and I had the mri today. However, he is now away for 3 weeks and wont be able to get the results of my mri until the follow up consultation.

    Essentially I have two questions

    1 Does my syrinx look like a dilated central canal or a syrinx? How do you differentiate between an early syrinx and a dilated central canal? The central canal is not visible on T1 weighted images.

    It seems to be quite a big coincidence that I have symptoms that relate to the same area as my syrinx.

    2 Since they have ruled out chiari and a tumour, I was wondering if my lumbar spine shows a tethered cord?

    Sorry again for such a lengthy post but many thanks for any help and advice


    http://postimg.org/image/m35hstbkv/
    http://s23.postimg.org/480na8k7f/ls_1.png
    http://s3.postimg.org/kjlu52l43/ls_2.png

  2. #2
    I can't help much, but I can tell you that per my neurosurgeon, tethering doesn't always show on MRI and sometimes it's not until they're in there that they can see whether there is tethering and the extent and/or complexity of the tethering. Also, people respond very differently to tethering - some folks are pretty much asymptomatic whereas others are highly symptomatic. I don't know where you are - if you're in the U.S. I would suggest reaching out to Dr. Falci at Craig in Colorado.

  3. #3


    Do you have a spinal cord injury?

    A syrinx is a cyst in the spinal cord caused by trauma or is congenital

    http://www.ninds.nih.gov/disorders/s...ingomyelia.htm

    pbr

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