The central syrinx of syryngomyelia may extend upward into the upper cervical cord and brainstem.


Clinical features of brainstem involvement:

(1) headache

(2) hand numbness

(3) pains in the hand, arms, shoulders and neck

(4) leg stiffness

(5) oscillopsia (wiggling or side-to-side movement of a visual object)

(6) diplopia

(7) vertigo

(8) nystagmus

(9) pseudobulbar palsy affecting cranial nerves IX to XII

(10) loss of facial sensation, especially around the mouth

(11) spastic paraparesis

(12) absent or reduced deep tendon reflexes in the upper extremity

(13) variable Charcot's joints

(14) variable Horner's syndrome

(15) variable bladder and/or bowel dysfunction


MRI is the preferred imaging technique to demonstrate the syrinx..



(1) hydrocephalus


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