Secondary sacral tethered cord syndrome after treatment of secondary cervical syringomyelia

• Verfasst von: Gubian, Arthur [VerfasserIn]
• Verfasst von: Rosahl, Steffen K. [VerfasserIn]
• Titel: Secondary sacral tethered cord syndrome after treatment of secondary cervical syringomyelia
• Verf.angabe: Arthur Gubian, Steffen K. Rosahl
• Jahr: 2019
• Jahr des Originals: 2018
• Umfang: 5 S.
• Fussnoten: Available online 22 November 2018 ; Gesehen am 15.05.2019
• Titel Quelle: Enthalten in: Journal of clinical neuroscience
• Ort Quelle: Burlington, Mass. : Harcourt, 1994
• Jahr Quelle: 2019
• Band/Heft Quelle: 61(2019), Seite 285-289
• ISSN Quelle: 1532-2653
• DOI: doi:10.1016/j.jocn.2018.11.010
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Chiari-like malformation
• Sach-SW: Posterior fossa surgery
• Sach-SW: Syringomyelia
• Sach-SW: Tethered cord
• K10plus-PPN: 1665685913

Abstract

A female patient operated at the age of 11 on a pilocytic astrocytoma in the posterior fossa, was re-operated for a recurrence 9years later. A Torkildsen drain was placed in the 4th ventricle and she remained asymptomatic for 15years before presenting again with acute hydrocephalus, tonsillar herniation, and a massive cervicothoracic syrinx. The symptoms retreated following craniocervical untethering and decompression. Two weeks later, however, she suffered from debilitating radiculopathy provoked by tethering of the cauda equina. Again, symptoms retreated completely after microsurgical intervention. This combination of a secondary Chiari-like malformation with cervical syringomyelia and tethering of the cauda equina in a single patient as a delayed complication of posterior fossa surgery has not been reported before. Diagnosis and treatment of lower tethered cord syndrome may be obscured and delayed in complex clinical situations. In particular, awareness to symptoms that are not related to syringomyelia is important in patients with a known syrinx and a history of posterior fossa surgery.