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Abstract
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Background and Aims Syringomyelia is characterized by the presence of spinal cord cavitation. It has multiple causes and is most commonly seen in association with Chiari I malformation. In these patients, the distribution of symptoms sometimes correlates with the anatomical location of the spinal cavitation. Dysesthesia is found in slightly less than half of the patients and it responds unpredictably and often poorly to currently available treatments. We present a case in which the dysesthesia could have been attributed to cervical syringomyelia, but the cause of this spinal finding remained elusive.
Methods 36-year-old female with history of Meniere’s disease and carpal tunnel syndrome presenting with numbness and tingling in her right arm and bilateral lower extremities for 1 year. She also reports having pain in her right arm, but not her legs. An MRI of the cervical spine showed central and right paracentral cervical spinal cord edema with small caliber syrinx from the levels of upper C3 through C6/7, moderate sized syrinx with the right hemi cord at C7 and partially visualized large multiseptated syrinx within the upper thoracic spinal cord from T1-T4. Her brain MRI ruled out Chiari’s malformation. A thoracic MRI found continuation of the syrinx and a mass at the level of T9. The patient underwent resection of the mass.
Tumor
Cervical spine MRI
Thoracic spine MRI
Conclusions Spinal cord ependymoma is a rare tumor and surgical resection has been established as first-line treatment and can be curative. This case illustrates that a complete spinal MRI is advisable when symptoms partially match the anatomic location but not the cause.
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