Editing Syringomyelia

{{Short description|Disorder in which a cyst forms in the spinal cord}}
{{Infobox medical condition (new)
| name            = Syringomyelia
| pronounce       = {{IPAc-en|s|ᵻ|ˌ|r|ɪ|ŋ|ɡ|ə|m|aɪ|ˈ|iː|l|i|ə|,_|-|ɡ|oʊ|-}}{{refn|{{Cite encyclopedia |url=http://www.lexico.com/definition/Syringomyelia |archive-url=https://web.archive.org/web/20200322182041/https://www.lexico.com/definition/syringomyelia |url-status=dead |archive-date=2020-03-22 |title=Syringomyelia |dictionary=[[Lexico]] UK English Dictionary |publisher=[[Oxford University Press]]}} }}{{refn|{{MerriamWebsterDictionary|access-date=2016-01-21|Syringomyelia}}}}
| image           = File:Syringomyelia (with arrow).png
| caption         = An idiopathic [[Syrinx (medicine)|syrinx]]
| field           = [[Neurosurgery]]
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'''Syringomyelia''' is a generic term referring to a disorder in which a [[cyst]] or cavity forms within the [[spinal cord]]. Often, syringomyelia is used as a generic term before an etiology is determined.<ref>{{cite book |first1=R. Shane |last1=Tubbs |first2=W. Jerry |last2=Oakes |chapter=Syringomyelia |pages=400–401 |chapter-url={{GBurl|kTzlC4UbFdcC|p=400}} |editor1-last=Lynn |editor1-first=D. Joanne |editor2-last=Newton |editor2-first=Herbert B. |editor3-last=Rae-Grant |editor3-first=Alexander D. |title=The 5-Minute Neurology Consult |date=2012 |publisher=Lippincott Williams & Wilkins |isbn=978-1-4511-0012-9 }}</ref> This cyst, called a [[Syrinx (medicine)|syrinx]], can expand and elongate over time, destroying the spinal cord. The damage may result in loss of feeling, [[paralysis]], weakness,<ref>{{cite journal |last1=Hilton |first1=Edith L. |last2=Henderson |first2=Lesley J. |title=Neurosurgical Considerations in Posttraumatic Syringomyelia |journal=AORN Journal |date=January 2003 |volume=77 |issue=1 |pages=135–150 |doi=10.1016/S0001-2092(06)61383-5 |pmid=12575629 }}</ref> and stiffness in the back, shoulders, and extremities. 

Syringomyelia may also cause a loss of the ability to feel extremes of hot or cold, especially in the hands. It may also lead to a cape-like bilateral loss of pain and temperature sensation along the upper chest and arms. The combination of symptoms varies from one patient to another depending on the location of the syrinx within the spinal cord, as well as its extent.

Syringomyelia has a prevalence estimated at 8.4 cases per 100,000 people,<ref>{{cite journal |title=PART III: Results |journal=Acta Neurologica Scandinavica |date=December 1966 |volume=42 |issue=S24 |pages=19–74 |doi=10.1111/j.1600-0404.1966.tb04773.x |doi-access=free }}</ref> with symptoms usually beginning in young adulthood. Signs of the disorder tend to develop slowly, although sudden onset may occur with coughing, straining, or [[myelopathy]].

== Signs and symptoms ==
Syringomyelia causes a wide variety of neuropathic symptoms, due to damage to the spinal cord. Patients may experience severe chronic pain, [[paresthesia|abnormal sensations]] and loss of sensation, particularly in the hands. Some patients experience [[paralysis]] or [[paresis]], temporarily or permanently. A syrinx may also cause disruptions in the [[parasympathetic]] and [[sympathetic nervous system]]s, leading to Horner syndrome, abnormal body temperature or sweating, bowel control issues, or other problems. If the syrinx is higher up in the spinal cord or affecting the brainstem, as in syringobulbia, [[Vocal cord paresis|vocal cord paralysis]], ipsilateral tongue wasting, [[trigeminal nerve]] sensory loss, and other signs may be present.<ref>{{cite book |last1=Greenberg |first1=David A. |last2=Aminoff |first2=Michael Jeffrey |last3=Simon |first3=Roger P. |chapter=Syringomyelia |pages=223– |title=Clinical Neurology |date=2002 |publisher=Lange Medical Books/McGraw-Hill |isbn=978-0-07-137543-6 }}</ref> Rarely, bladder stones can occur at the onset of weakness in the lower extremities.<ref>{{cite journal |doi=10.11477/mf.1413100675 |date=2006 |volume=60 |last1=西田 |first1=智保 |last2=山川 |first2=克典 |last3=高橋 |first3=剛. |title=症例 脊髄空洞症に合併した膀胱結石 |trans-title=A large bladder stone caused by syringomyelia |journal=臨床泌尿器科 |trans-journal=Clinical Urology |language=ja }}</ref>
Classically, syringomyelia spares the [[dorsal column]]/[[medial lemniscus]] of the spinal cord, leaving pressure, vibration, touch and [[proprioception]] intact in the upper extremities. [[Neuropathic arthropathy]], also known as a Charcot joint, can occur, particularly in the shoulders, in patients with syringomyelia.<ref>{{cite journal |last1=Hirsch |first1=M. |last2=San Martin |first2=M. |last3=Krause |first3=D. |title=Neuropathic osteoarthropathy of the shoulder secondary to syringomyelia |journal=Diagnostic and Interventional Imaging |date=March 2021 |volume=102 |issue=3 |pages=193–194 |doi=10.1016/j.diii.2020.09.010 |pmid=33092999 }}</ref> The loss of sensory fibers to the joint is theorized to lead to degeneration of the joint over time.<ref>[http://www.medscape.com/viewarticle/496650_2 "Neuropathic Arthropathy of the Shoulder (Charcot Shoulder): Clinical Commentary"] Medscape. Accessed 9 January 2011.</ref>

== Cause ==
Generally, there are two forms of syringomyelia: congenital and acquired. Syringomyelia is generally a chronic disorder that occurs over time, resulting in muscular atrophy. Acquired Syringomyelia can be caused by a serious physical trauma to the body such as in a road traffic accident. Syringomyelia can also be classified into communicating and noncommunicating forms. Communicating typically occurs due to lesions on the foramen magnum and noncommunicating occurring due to other spinal cord diseases.<ref>{{cite book |last1=Byrne |title=Diseases of the Spine and Spinal Cord}}</ref>

===Congenital===
The first major form relates to an abnormality of the brain called an [[Arnold–Chiari malformation]] or Chiari malformation. This is the most common cause of syringomyelia, where the anatomic abnormality, which may be due to a small posterior fossa, causes the lower part of the [[cerebellum]] to protrude from its normal location in the back of the head into the cervical or neck portion of the spinal canal. A syrinx may then develop in the cervical region of the spinal cord. Here, symptoms usually begin between the ages of 25 and 40 and may worsen with straining, called a [[Valsalva maneuver#Pain management|valsalva maneuver]], or any activity that causes [[cerebrospinal fluid]] pressure to fluctuate suddenly. Some patients, however, may have long periods of stability. Some patients with this form of the disorder also have [[hydrocephalus]], in which cerebrospinal fluid accumulates in the skull, or a condition called [[arachnoiditis]], in which a covering of the spinal cord—the arachnoid membrane—is inflamed.<ref>{{Cite web|url=https://www.webmd.com/pain-management/guide/pain-management-arachnoiditis#1|title=Pain Management: Arachnoiditis|editor=Carol DerSarkissian, MD|website=[[WebMD]]|date=11 November 2021|archive-url=https://web.archive.org/web/20220125151704/https://www.webmd.com/pain-management/guide/pain-management-arachnoiditis|archive-date=25 January 2022|url-status=live}}</ref>  Some cases of syringomyelia are familial, although this is rare.<ref>{{cite web|url=https://www.malacards.org/card/syringomyelia#:~:text=the%20initial%20injury.-,Some%20cases%20of%20syringomyelia%20are%20familial%20%2C%20although%20this%20is%20rare,be%20required%20in%20some%20patients.|title=Syringomyelia|website=[[GeneCards|GeneCardsSuite]]|archive-url=https://web.archive.org/web/20220302100451/https://www.malacards.org/card/syringomyelia|archive-date=2 March 2022}}</ref>

===Acquired===
The second major form of syringomyelia occurs as a complication of [[Physical trauma|trauma]], [[meningitis]], [[hemorrhage]], a [[tumor]], or [[arachnoiditis]]. Here, the syrinx or cyst develops in a segment of the spinal cord damaged by one of these conditions. The syrinx then starts to expand. This is sometimes referred to as noncommunicating syringomyelia. Symptoms may appear months or even years after the initial injury, starting with pain, weakness, and sensory impairment originating at the site of trauma.<ref>{{cite book |last1=Shenoy |first1=Varadaraya Satyanarayan |last2=Munakomi |first2=Sunil |last3=Sampath |first3=Raghuram |title=StatPearls |date=2024 |publisher=StatPearls Publishing |chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK537110/ |chapter=Syringomyelia |pmid=30725795 }}</ref>

The primary symptom of post-traumatic syringomyelia (often referred to using the abbreviation of PTS)<ref name="pmid8558154">{{cite journal |vauthors=Schurch B, Wichmann W, Rossier AB |title=Post-traumatic syringomyelia (cystic myelopathy): a prospective study of 449 patients with spinal cord injury |journal=J. Neurol. Neurosurg. Psychiatry |volume=60 |issue=1 |pages=61–7 |date=January 1996 |pmid=8558154 |pmc=486191 |doi= 10.1136/jnnp.60.1.61}}</ref> is pain, which may spread upward from the site of injury. Symptoms, such as pain, numbness, weakness, and disruption in temperature sensation, may be limited to one side of the body. Syringomyelia can also adversely affect sweating, sexual function, and, later, bladder and bowel control. A typical cause of PTS would be a car accident or similar trauma involving a whiplash injury.{{fact|date=December 2024}}

What can make PTS difficult to diagnose is the fact that symptoms can often first appear long after the actual cause of the syrinx occurred (e.g., a car accident occurring and then the patient first experiencing PTS symptoms such as pain, loss of sensation, and reduced ability on the skin to feel varying degrees of hot and cold a number of months after the car accident).<ref name="NINDS Syringomyelia"/>

== Pathogenesis ==
The pathogenesis of syringomyelia is debated. The cerebrospinal fluid also serves to cushion the [[Human brain|brain]]. Excess cerebrospinal fluid in the [[central canal]] of the [[spinal cord]] is called hydromyelia. This term refers to increased cerebrospinal fluid that is contained within the [[ependyma]] of the central canal.  When fluid dissects into the surrounding [[white matter]] forming a cystic cavity or [[Syrinx (medicine)|syrinx]], the term syringomyelia is applied.  As these conditions coexist in the majority of cases, the term syringohydromyelia is applied. The terms are used interchangeably.<ref>{{Cite journal |last1=Koyanagi |first1=Izumi |last2=Houkin |first2=Kiyohiro |date=2010 |title=Pathogenesis of syringomyelia associated with Chiari type 1 malformation: review of evidences and proposal of a new hypothesis |journal=Neurosurgical Review |volume=33 |issue=3 |pages=271–284; discussion 284–285 |doi=10.1007/s10143-010-0266-5 |pmid=20532585 }}</ref>

It has been observed that obstruction of the cerebrospinal fluid spaces in the subarachnoid space can result in syrinx formation, and alleviation of the obstruction may improve symptoms.  A number of pathological conditions can cause an obstruction of the normal cerebrospinal fluid spaces. These include [[Chiari malformation]], spinal [[arachnoiditis]], [[scoliosis]], spinal [[vertebrae]] misalignment, spinal [[tumors]], [[spina bifida]], and others.  The reasons that blockage of the cerebrospinal fluid space within the subarachnoid space can result in syrinx formation are not fully understood although a small posterior fossa is one known cause.  It is unclear if syrinx fluid originates from bulk movement of cerebrospinal fluid into the spinal cord, from bulk transmural movement of blood fluids through the spinal [[vasculature]] into the syrinx, or from a combination of both. Recent work suggests that central nervous system compliance is the underlying problem for the central nervous system, and also that hydrocephalus and syringomyelia have related causes.<ref>{{Cite journal |last1=Heiss |first1=John D |last2=Jarvis |first2=Katie |last3=Smith |first3=René K |last4=Eskioglu |first4=Eric |last5=Gierthmuehlen |first5=Mortimer |last6=Patronas |first6=Nicholas J |last7=Butman |first7=John A |last8=Argersinger |first8=Davis P |last9=Lonser |first9=Russell R |last10=Oldfield |first10=Edward H |date=2019 |title=Origin of Syrinx Fluid in Syringomyelia: A Physiological Study |journal=Neurosurgery |volume=84 |issue=2 |pages=457–468 |doi=10.1093/neuros/nyy072 |pmc=6500882 |pmid=29618081 }}</ref>

== Diagnosis ==
[[Image:Gray 111 - Vertebral column-coloured.png|120px|thumb]]

Physicians now use magnetic resonance imaging (MRI) to diagnose syringomyelia. The MRI radiographer takes images of body anatomy, such as the brain and spinal cord, in vivid detail. This test will show the syrinx in the spine or any other conditions, such as the presence of a tumor. MRI is safe, painless, and informative and has greatly improved the diagnosis of syringomyelia.<ref>{{cite book |doi=10.1007/978-3-319-68536-6_12 |chapter=Imaging of Spinal CSF Disorders: Syringomyelia |title=Clinical Neuroradiology |date=2019 |last1=Pavaine |first1=Julija |last2=Thompson |first2=Dominic |pages=519–544 |isbn=978-3-319-68535-9 }}</ref>

The physician may order additional tests to help confirm the diagnosis. One of these is called [[electromyography]] (EMG), which show possible lower motor neuron damage.<ref>{{cite book |last1=Ramroop |first1=Hillary |last2=Cruz |first2=Ricardo |title=StatPearls |date=2024 |publisher=StatPearls Publishing |chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK563178/ |chapter=Electrodiagnostic Evaluation of Motor Neuron Disease |pmid=33085325 }}</ref> Note this test isn't used diagnostically for injuries to the spine but to nerves and muscles. This would be part of a patient's rehab routine. In addition, [[computed axial tomography]] (CT) scans of a patient's head may reveal the presence of tumors and other abnormalities such as hydrocephalus.<ref>{{cite journal |last1=Rub |first1=Salsabeel Abu Al |last2=Alaiad |first2=Ahmad |last3=Hmeidi |first3=Ismail |last4=Quwaider |first4=Muhannad |last5=Alzoubi |first5=Omar |title=Hydrocephalus classification in brain computed tomography medical images using deep learning |journal=Simulation Modelling Practice and Theory |date=February 2023 |volume=123 |pages=102705 |doi=10.1016/j.simpat.2022.102705 }}</ref>

Like MRI and CT scans, another test, called a [[myelogram]], uses radiographs and requires a contrast medium to be injected into the subarachnoid space. Since the introduction of MRI, this test is rarely necessary to diagnose syringomyelia.<ref>{{Cite journal |last1=Hoeffner |first1=E.G. |last2=Mukherji |first2=S.K. |last3=Srinivasan |first3=A. |last4=Quint |first4=D.J. |date=2012 |title=Neuroradiology Back to the Future: Spine Imaging |journal=American Journal of Neuroradiology |volume=33 |issue=6 |pages=999–1006 |doi=10.3174/ajnr.A3129 |pmc=8013253 |pmid=22576888 }}</ref>

The possible causes are trauma, tumors, and congenital defects. It is most usually observed in the part of the spinal cord corresponding to the neck area. Symptoms are due to spinal cord damage and include pain, decreased sensation of touch, weakness, and loss of muscle tissue. The diagnosis is confirmed with a spinal CT, myelogram or MRI of the spinal cord. The cavity may be reduced by surgical decompression.<ref>{{cite web |title=Spinal Cord Injury |url=https://www.ninds.nih.gov/health-information/disorders/spinal-cord-injury |website=National Institute of Neurological Disorders and Stroke }}</ref>

Furthermore, evidence also suggests that impact injuries to the thorax area highly correlate with the occurrence of a cervical-located syrinx.<ref>{{Cite journal |last1=Kleindienst |first1=Andrea |last2=Laut |first2=Francisco Marin |last3=Roeckelein |first3=Verena |last4=Buchfelder |first4=Michael |last5=Dodoo-Schittko |first5=Frank |date=2020 |title=Treatment of posttraumatic syringomyelia: evidence from a systematic review |journal=Acta Neurochirurgica |volume=162 |issue=10 |pages=2541–2556 |doi=10.1007/s00701-020-04529-w |pmc=7496040 |pmid=32820376 }}</ref>

== Treatment ==

===Surgery===
Treating syringomyelia sometimes requires [[surgery]]. Surgery involving the spinal cord carries certain risks, and as with any medical treatment, the potential benefits have to be weighed against the possible complications. On the other hand, delaying treatment can increase the risk of permanent damage. Evaluation of the condition is necessary because syringomyelia can remain stationary for long periods of time, and in some cases progress rapidly.<ref>{{cite web |title=Chiari malformation |url=https://www.nhs.uk/conditions/chiari-malformation/ |website=NHS UK |date=18 October 2017 }}</ref>

The main goal of surgical intervention is to correct the condition which led to the formation of the syrinx. Draining the syrinx can also help, by preventing it from becoming worse, but the symptoms the syrinx has already caused may not go away.{{citation needed|date=December 2020}}

In cases involving an [[Arnold–Chiari malformation]], the main goal of surgery is to provide more space for the [[cerebellum]] at the base of the skull and upper [[Neck#Anatomy of the human neck|cervical spine]], without entering the brain or spinal cord. This often causes the syrinx to shrink or disappear over time, as the normal flow of [[cerebrospinal fluid]] is restored. If syringomyelia is caused by a [[tumor]], removing the tumor – if possible – is the treatment of choice.<ref>{{cite web |title=Chiari Malformations |url=https://www.ninds.nih.gov/health-information/disorders/chiari-malformations |website=National Institute of Neurological Disorders and Stroke }}</ref>

Most patients’ symptoms stabilize or have a modest improvement following surgery. Syringomyelia can come back, however, requiring additional surgeries which may be less effective.<ref>{{Cite journal |last1=Attenello |first1=Frank J. |last2=McGirt |first2=Matthew J. |last3=Gathinji |first3=Muraya |last4=Datoo |first4=Ghazala |last5=Atiba |first5=April |last6=Weingart |first6=Jon |last7=Carson |first7=Benjamin |last8=Jallo |first8=George I. |date=2008 |title=Outcome of Chiari-associated syringomyelia after hindbrain decompression in children: analysis of 49 consecutive cases |journal=Neurosurgery |volume=62 |issue=6 |pages=1307–1313; discussion 1313 |doi=10.1227/01.neu.0000333302.72307.3b |pmid=18824997 }}</ref>

In some cases, including both communicating and non-communicating forms of the condition, a syrinx may require ongoing drainage. This is done with a [[Shunt (medical)|shunt]], which uses tubes and valves to let [[cerebrospinal fluid]] (CSF) drain from the syrinx into another cavity within the body (usually the abdomen). This type of shunt, called a ventriculoperitoneal shunt, is particularly useful in cases involving [[hydrocephalus]]. By continually draining the syrinx, a shunt can arrest the progression of symptoms and relieve pain, headache, and tightness.<ref>{{Cite journal |last1=Williams |first1=B. |last2=Sgouros |first2=S. |last3=Nenji |first3=E. |date=1995 |title=Cerebrospinal fluid drainage for syringomyelia |journal=European Journal of Pediatric Surgery |volume=5 |issue=Suppl 1 |pages=27–30 |doi=10.1055/s-2008-1066259 |pmid=8770575 }}</ref>

Many factors affect the decision to use a shunt. There are risks of injury to the spinal cord, infection, drainage becoming blocked, and bleeding, and they do not always achieve the intended results. Draining the fluid more quickly does not produce better outcomes, but for some syrinxes, a shunt is the only drainage option.<ref>{{Cite web |date=2018-10-03 |title=Hydrocephalus - Complications |url=https://www.nhs.uk/conditions/hydrocephalus/complications/ |access-date=2022-11-14 |website=nhs.uk |language=en}}</ref>

In the case of trauma-related syringomyelia, the surgeon operates at the level of the initial injury. The syrinx collapses at surgery, but a tube or shunt is usually necessary to prevent it from returning.<ref>{{Cite journal |last1=Byun |first1=Min Seok |last2=Shin |first2=Jun Jae |last3=Hwang |first3=Yong Soon |last4=Park |first4=Sang Keun |date=2010 |title=Decompressive Surgery in a Patient with Posttraumatic Syringomyelia |journal=Journal of Korean Neurosurgical Society |volume=47 |issue=3 |pages=228–231 |doi=10.3340/jkns.2010.47.3.228 |pmc=2851081 |pmid=20379479 }}</ref>

===Non-surgical interventions===
Surgery is not always recommended for syringomyelia patients. While there is no medication which can cure the condition, for many patients, the main treatment is [[analgesia]] to manage the symptoms. Physicians specializing in pain management can develop a medication and treatment plan to ameliorate pain. Medications to combat any neuropathic pain symptoms such as shooting and stabbing pains (e.g. [[gabapentin]] or [[pregabalin]]) would be first-line choices. Opiates are usually prescribed for pain for management of this condition. Conversely, [[facet joint injections]] are not indicated for the treatment of syringomyelia.<ref>{{Citation |last1=Schug |first1=Stephan A. |title=Treatment of Neuropathic Pain |date=2011 |url=http://www.ncbi.nlm.nih.gov/books/NBK534257/ |work=Mechanisms of Vascular Disease: A Reference Book for Vascular Specialists |editor-last=Fitridge |editor-first=Robert |place=Adelaide (AU) |publisher=University of Adelaide Press |isbn=978-0-9871718-2-5 |pmid=30485013 |access-date=2022-11-14 |last2=Stannard |first2=Kathryn JD |editor2-last=Thompson |editor2-first=Matthew}}</ref>

[[Radiation]] is rare, but may be used if a tumor is involved. In these cases, it can halt the extension of a cavity and may help to alleviate pain.<ref>{{cite book |title=Syringomyelia |date=January 1994 |publisher=U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health |location=University of California Riverside |pages=4 |url=https://books.google.com/books?id=5Y_oUJDUHtcC&dq=Drugs+have+no+curative+value+as+a+treatment+for+syringomyelia.+Radiation+is+used+rarely,+and+is+of+little+benefit+except+in+the+presence+of+a+tumor.+In+these+cases,+it+can+halt+the+extension+of+a+cavity+and+may+help+to+alleviate+pain&pg=PP6 |access-date=April 19, 2022}}</ref>

Treatment is usually reserved for cases which are causing symptoms. Treatment may not provide enough benefits to be recommended for elderly patients, or when symptoms are stable instead of worsening. Whether treated or not, many patients are advised to avoid activities that involve straining.<ref name="NINDS Syringomyelia">{{cite web |title=Syringomyelia |url=https://www.ninds.nih.gov/health-information/disorders/syringomyelia |website=National Institute of Neurological Disorders and Stroke }}</ref>

A conservative approach may be recommended, as the natural history of syringomyelia is not yet well understood. When surgery is not currently advised, patients are monitored with regular physical evaluations and MRI's.<ref>{{Cite journal |last1=Kanga |first1=Ismat |last2=Wong |first2=Jessica J. |last3=Stern |first3=Paula J. |date=2014 |title=Detection of syringomyelia in a pediatric patient with mild scoliosis: a case report |journal=The Journal of the Canadian Chiropractic Association |volume=58 |issue=1 |pages=16–23 |pmc=3924508 |pmid=24587493 }}</ref>

== Research ==
[[File:Cervical MRI 120744 rgbca.png|thumb]]
The precise causes of syringomyelia are still unknown, although blockage of the flow of cerebrospinal fluid has been known to be an important factor since the 1970s. Scientists in the UK and US continue to explore the mechanisms that lead to the formation of syrinxes in the spinal cord. It has been demonstrated that a block of the free flow of cerebrospinal fluid is a contributing factor in the pathogenesis of the disease. Duke University in America and Warwick University are conducting research to explore genetic features of syringomyelia.<ref>{{ClinicalTrialsGov|NCT01060800|The Genetics of Chiari Type I Malformation}}</ref>

Surgical techniques are also being refined by the neurosurgical research community. Successful procedures expand the area around the cerebellum and spinal cord, improving the flow of cerebrospinal fluid and thereby reducing the syrinx.<ref>{{cite journal |last1=Vandertop |first1=W. |title=Syringomyelia |journal=Neuropediatrics |date=22 November 2013 |volume=45 |issue=1 |pages=003–009 |doi=10.1055/s-0033-1361921 |pmid=24272770 |doi-access=free }}</ref>

It is also important to understand the role of birth defects in the development of hindbrain malformations that can lead to syringomyelia, as syringomyelia is a feature of intrauterine life and is also associated with spina bifida. Learning when these defects occur during the development of the fetus can help with the understanding of this and similar disorders, and may lead to preventive treatment that can stop the formation of some birth abnormalities.<ref>{{cite book |editor1-last=Bale |editor1-first=Judith R. |editor2-last=Stoll |editor2-first=Barbara J. |editor3-last=Lucas |editor3-first=Adetokunbo O. |title=Reducing Birth Defects: Meeting the Challenge in the Developing World |date=2003 |publisher=National Academies Press |chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK222083/ |chapter=Interventions to Reduce the Impact of Birth Defects }}</ref>

Diagnostic technology is another area for continued research. MRI has enabled scientists to see the situation within the spine, including syringomyelia, before any symptoms appear. A new technology, known as dynamic MRI, allows investigators to view spinal fluid flow within the syrinx. CT scans allow physicians to see abnormalities in the brain, and other diagnostic tests have also improved greatly with the availability of new, non-toxic, contrast dyes.<ref>{{cite journal |last1=Williams |first1=Gwendolyn |last2=Thyagaraj |first2=Suraj |last3=Fu |first3=Audrey |last4=Oshinski |first4=John |last5=Giese |first5=Daniel |last6=Bunck |first6=Alexander C. |last7=Fornari |first7=Eleonora |last8=Santini |first8=Francesco |last9=Luciano |first9=Mark |last10=Loth |first10=Francis |last11=Martin |first11=Bryn A. |title=In vitro evaluation of cerebrospinal fluid velocity measurement in type I Chiari malformation: repeatability, reproducibility, and agreement using 2D phase contrast and 4D flow MRI |journal=Fluids and Barriers of the CNS |date=December 2021 |volume=18 |issue=1 |page=12 |doi=10.1186/s12987-021-00246-3 |pmc=7977612 |pmid=33736664 |doi-access=free }}</ref>

== See also ==
* [[Brown-Séquard syndrome]]
* [[Central cord syndrome]]
* [[Dissociated sensory loss]]
* [[Ependymoma]], a type of tumors that are capable of causing syringomyelia
* [[Otto Kahler]], a neurologist in the late 1800s who published the first complete description of syringomyelia.
* [[Peter McFarline]], Australian sports writer who had syringomyelia
* [[Scoliosis]] is sometimes caused by syringomyelia.
* [[Chiari Malformation]]
* [[Syringobulbia]]
* [[Ehlers Danlos Syndrome]]
* [[Ehlers-Danlos Society]]
* [[Hypermobility spectrum disorder]]

== References ==
{{Reflist}}

== External links ==
{{Commons category}}
* {{NINDS|Syringomyelia}}

{{Spinal cord lesions}}
{{Congenital malformations and deformations of nervous system}}
{{Medical resources
| DiseasesDB      = 12769
| ICD11           = {{ICD11|8D66}}, {{ICD11|LA07.3}}
| ICD10           = {{ICD10|G|95|0|g|90}}, {{ICD10|Q|06|4|q|00}}
| ICD9            = {{ICD9|336.0}} {{ICD9|742.53}}
| ICDO            =
| OMIM            = 272480
| MedlinePlus     = 001398
| eMedicineSubj   = neuro
| eMedicineTopic  = 359
| MeshID          = D013595
| oMIM_mult       = {{OMIM2|186700}}
| Orphanet        = 3280
}}
{{Authority control}}

[[Category:Neurocutaneous conditions]]
[[Category:Rare diseases]]
[[Category:Congenital disorders of nervous system]]
[[Category:Spinal cord disorders]]