Very Early Detected Asymptomatic Posttraumatic Syrinx in a Patient with Spinal Cord Injury

Abstract

Aims: Posttraumatic syringomyelia (PTS) is a devastating complication of spinal cord injury (SCI) because of its association with delayed neurological deterioration. In our case report, diagnosis of very early detected asymptomatic syrinx in a patient with incomplete SCI was made incidentally according to cervical spinal magnetic resonance imaging (MRI) performed for unrelated purposes 32 days after the injury and conservative management was considered with periodic spinal MRI and neurologic examination to monitor the progression of syrinx during four years follow up. The present case report is the first to define syrinx at a very early stage in a patient with traumatic incomplete SCI. Presentation of Case: 19 year-old male patient sustained C4 and C5 linear vertebral lamina fractures and adjacent cord concussion due to a diving accident four years ago. On presentation at the rehabilitation unit, he was diagnosed as C5 American Spinal Cord Injury Association (ASIA) grade C tetraplegia according to his physical examination. On completion of the comprehensive rehabilitation programme, the patient showed gradual neurological improvement and was diagnosed as C5 ASIA D SCI. During four years of follow up syrinx had good prognosis by means of both clinical and radiologic findings. There were no symptoms or signs related to PTS, also periodic cervical spinal MRI performed annually showed no change in the size of syrinx. Conclusion: We conclude that posttraumatic syrinx should be considered even in the earlier stages of the postinjury recovery period and syrinx which are particularly limited and asymptomatic could be followed up conservatively with close clinical and radiological observation.