Download PDF
Radiologie up2date 2005; 5(1): 53-64
DOI: 10.1055/s-2005-861163
Neuroradiologie
© Georg Thieme Verlag KG Stuttgart · New York

Chronisches spinales Trauma

Chronic Spinal TraumaM.  Freund1
  • 1Institut für Radiologie und Neuroradiologie Aschaffenburg
Further Information

Publication History

Publication Date:
31 March 2005 (online)

Also available at
    Permissions and Reprints All articles of this category

Zusammenfassung

Im vorliegenden Artikel sind die Ursachen und Folgen von chronischen spinalen Traumen dargestellt. Neben der häufig entscheidenden Anamnese und klinischen Beschwerdesymptomatik sind die bildgebenden Verfahren hinsichtlich ihrer Bedeutung in der Diagnostik des chronischen spinalen Traumas gewertet. Untersuchungsprotokolle werden vorgestellt. Diagnostische Verfahren der Wahl in der Darstellung des chronischen spinalen Traumas sind die Magnetresonanztomographie (MRT) und die Mehrzeilencomputertomographie (MSCT).

Abstract

Posttraumatic syringomyelia (PTS) is one of the most common complications in para- or tetraplegic patients. Para- or tetraplegic patients presenting with clinical deterioration have often developed a posttraumatic syringomyelia. Magnetic resonance imaging (MRI) and multislice computed tomography (MSCT) are very sensitive in detecting PTS. This article describes the typical clinical findings and the characteristic MSCT and MRI changes of PTS.

Key words

Chronic spinal trauma - Magnetic resonance imaging - Computed tomography - Posttraumatic syringomyelia

Literatur

  • 1 Heinz R, Curnes J, Friedman A, Oakes J. Exophytic syrinx, an extreme forme of syringmyelia: CT, myelographic and MR features.  Radiology. 1992;  183 243-246
    PubMedGoogle Scholar
  • 2 Tanghe H LJ. Magnetic Resonance Imaging (MRI) in Syringomyelia.  Acta Neurochirurgica. 1995;  134 93-99
    CrossrefPubMedGoogle Scholar
  • 3 Brodbelt A R, Stoodley M A. Posttraumatic syringomyelia: a review.  J Clin Neurosci. 2003;  10 401-408
    CrossrefPubMedGoogle Scholar
  • 4 Freund M, Aschoff A, Spahn B, Sartor K. Die Posttraumatische Syringomyelie.  Fortschr Roentgenstr. 1999;  171 417-423
    PubMedGoogle Scholar
  • 5 Hirai T, Korogi Y, Shigematsu Y, Sugahara T, Takahshi M, Ushio Y, Uemura S. Evaluation of syringomyelia with three-dimensional constructive interference in a steady state (CISS) sequence.  Journal of Magnetic Resonance Imaging. 2000;  11 120-126
    CrossrefPubMedGoogle Scholar
  • 6 Ball M J, Dayan A D. Pathogenesis of Syringomyelia.  Lancet. 1972;  2 799-801
    PubMedGoogle Scholar
  • 7 Barnett H JM, Jousse A T. Post-traumatic-syringomyelia (cystic myelopathy). in: Handbook of Clinical Neurology.  Amsterdam: North Holland. 1976;  26 113-157
    PubMedGoogle Scholar
  • 8 Schurch B, Wichmann W, Rossier A B. Post-traumatic syringmyelia (cystic myelopathy): a prospective study of 449 patients with spinal cord injury.  J Neurol Neurosurg Psychiatry. 1996;  60 61-67
    CrossrefPubMedGoogle Scholar
  • 9 Williams B. Post-traumatic Syringomyelia, an Update.  Paraplegia. 1990;  28 296-313
    PubMedGoogle Scholar
  • 10 Wozniewicz B, Filipowicz K, Swiderska S K, Deraka K. Pathophysiological mechanism of the traumatic cavitation of the spinal cord.  Paraplegia. 1983;  21 312-317
    PubMedGoogle Scholar
  • 11 Abel R, Gerner H J, Smit C, Meiners T. Residual deformity of the spinal canal in patients with traumatic paraplegia and secondary changes of the spinal cord.  Spinal Cord. 1999;  37 14-19
    CrossrefPubMedGoogle Scholar
  • 12 Aito S, El Masry W S, Gerner H J, di Lorenzo N, Pellicanò G, D’Andrea , Fromm B, Freund M. Ascending myelopathy in the early stage of spinal cord injury.  Spinal Cord. 1999;  37 617-623
    CrossrefPubMedGoogle Scholar
  • 13 Bartholdi D, Schwab M E. Methylprednisolone inhibits early inflammatory processes but not ischemic cell death after experimental spinal cord lesion in the rat.  Brain Res. 1995;  672 177-186
    CrossrefPubMedGoogle Scholar
  • 14 Bracken M B. Treatment of spinal cord injury with methylprednisolone: results of a multicenter, randomized clinical trial.  J Neurotrauma. 1991;  8 47-50
    PubMedGoogle Scholar
  • 15 Dusart D, Schwab M E. Secondary cell death and the inflammatory reaction after dorsal hemisection of the rat spinal cord.  Eur J Neurosc. 1994;  5 712-725
    PubMedGoogle Scholar
  • 16 Schwartz E D, Falcone S F, Quencer R M, Green B A. Posttraumatic syringomyelia: pathogenesis, imaging, and treatment.  Am J Roentgenol. 1999;  173 487-492
    PubMedGoogle Scholar
  • 17 Williams B. Syringomyelia.  Neurosurg Clin North Am. 1990;  1 653-685
    PubMedGoogle Scholar
  • 18 Bastian H C. On a case of concussion-lesion with extensive secondary degeneration of the spinal cord.  Proceedings of the Royal Medical and Chirurgical Society of London. 1867;  50 499
    PubMedGoogle Scholar
  • 19 Schwartz E D, Yezierski R P, Pattany P M, Quencer R M, Weaver R G. Diffusion-Weighted MR Imaging in a Rat Model of Syringomyelia after Excitotoxic Spinal Cord Injury.  Am J Neuroradiol. 1999;  20 1422-1428
    PubMedGoogle Scholar
  • 20 Williams B. Progress in Syringomyelia.  Neurol Res. 1986;  8 130-145
    PubMedGoogle Scholar
  • 21 Backe H A. et al . Post-traumatic spinal cord cysts evaluated by magnetic resonance imaging.  Paraplegia. 1991;  29 607-612
    PubMedGoogle Scholar
  • 22 Curati W L, Kingsley D P, Kendall B E, Moseley I F. MRI in chronic spinal cord trauma.  Neuroradiology. 1992;  35 30-35
    CrossrefPubMedGoogle Scholar
  • 23 Jinkins J R, Reddy S, Leite C C, Bazan C 3rd, Xiong L. MR of parenchymal spinal cord signal change as a sign of active advancement in clinically progressive posttraumatic syringmyelia.  Am J Neuroradiol. 1998;  19 177-182
    PubMedGoogle Scholar
  • 24 Sgouros S, Williams B. A critical appraisal of drainage in syringomyelia.  J Neurosurg. 1995;  82 1-10
    CrossrefPubMedGoogle Scholar
  • 25 Shannon N, Symon L, Logue V. Clinical features, investigation and treatment of posttraumatic syringomyelia.  J Neurol Neurosurg Psychiatry. 1981;  44 35-42
    PubMedGoogle Scholar
  • 26 Tobimatsu Y, Nihei R, Kimura T, Suyama T, Kimura H, Tobimatsu H, Shirakawa T. A quantitative analysis of cerebrospinal fluid in post-traumatic syringmyelia.  Paraplegia. 1995;  33 203-207
    PubMedGoogle Scholar
  • 27 Wang D, Bodley R, Sett P, Gardner B, Frankel H. A clinical magnetic resonance imaging study of the traumatised cord more than 20 years following injury.  Paraplegia. 1996;  34 65-81
    PubMedGoogle Scholar
  • 28 Freund M, Adwan M, Kooijman H, Heiland S, Thomsen M, Hähnel S, Jensen K, Gerner H J, Sartor K. MR-tomographische Liquorflussmessungen am Spinalkanal mit einem optimierten MRT-Protokoll: Experimentelle und klinische Untersuchungen.  Fortschr Roentgenstr. 2001;  173 306-314
    PubMedGoogle Scholar
  • 29 Mau H, Nebinger G. Die Schultergelenksarthropathie bei der Syringomyelie.  Z Orthop. 1986;  124 157-164
    PubMedGoogle Scholar
  • 30 Sett P, Crockard H A. The value of magnetic resonance imaging (MRI) in the follow up managment of spinal injury.  Paraplegia. 1991;  29 396-410
    PubMedGoogle Scholar
  • 31 Vannemreddy S S, Rowed D W, Bharatwal N. Posttraumatic syringomyelia: predisposing factors.  Br J Neurosurg. 2002;  16 276-283
    CrossrefPubMedGoogle Scholar
  • 32 Tachibana S, Kitahara Y, Lida H, Yada K. Spinal cord intramedullary pressure. A possible factor in syrinx growth.  Spine. 1994;  19 2174-2179
    PubMedGoogle Scholar
  • 33 Heiss J D, Patronas N, DeVroom H L. et al . Elucidating the pathophysiology of syringomyelia.  J Neurosurg. 1999;  91 553-562
    CrossrefPubMedGoogle Scholar
  • 34 Potter K, Saifuddin A. MRI of chronic spinal cord injury.  Br J Radiol. 2003;  76 347-352
    PubMedGoogle Scholar
  • 35 Harvey C, Wilson S E, Greene C G, Berkowitz M, Stripling T E. New estimates of the direct costs of traumatic spinal cord injuries: results of nationwide survey.  Paraplegia. 1992;  30 834-850
    PubMedGoogle Scholar
  • 36 Durward Q J, Rice G P, Ball M J. et al . Selective spinal cordectomy: clinicopathological correlation.  Journal of Neurosurgery.. 1982;  56 359-367
    PubMedGoogle Scholar
  • 37 Stripling T E. The cost of spinal cord injury: the economic consequences of traumatic spinal cord injury.  Paraplegia News. 1990;  August 50-54
    PubMedGoogle Scholar

PD Dr. Michael Freund

Klinikum Aschaffenburg, Institut für Radiologie und Neuroradiologie

Am Hasenkopf 1 · 63736 Aschaffenburg

Phone: 06021/32 3100

Fax: 06021/32 3105

Email: michael.freund@klinikum-aschaffenburg.de

      >