Establishing the Physiology of Syringomyelia

Oldfield, E H.

Abstract

The purpose of this study is to establish the mechanism(s) of progression of communicating syringomyelia. Communicating syringomyelia usually accompanies abnormalities at the craniocervical junction. Measurement of intraventricular pressure, intrathecal pressure, and intrasyrinx pressure should provide data which elucidate the hydrodynamic mechanism(s) of progression of syringomyelia. Radiographic testing, including MRI flow studies, ultrasonography, and Imatron CT, will demonstrate how pathologic anatomy alters normal cerebrospinal fluid (CSF) flow. The effect of posterior fossa craniectomy, upper cervical laminectomy, and duraplasty on CSF flow, syrinx size, and neurologic function will be evaluated. One patient has been treated to date. The pressure measurements were performed without complication. CSF circulation at the foramen magnum improved with surgery in this patient. The syrinx decreased in size following surgery We plan to proceed with an additional nine patients.

Funding Agency

• Agency: National Institute of Health (NIH)
• Institute: National Institute of Neurological Disorders and Stroke (NINDS)
• Type: Intramural Research (Z01)
• Project #: 1Z01NS002854-01
• Application #: 3846330
• Support Year: 1
• Fiscal Year: 1992

Institution

• Name: National Institute of Neurological Disorders and Stroke
• Country: United States

Publications

Hansen-Schwartz, Jacob; Vajkoczy, Peter; Macdonald, Robert Loch et al. (2007) Cerebral vasospasm: looking beyond vasoconstriction. Trends Pharmacol Sci 28:252-6

Lonser, Russell R; Butman, John A; Oldfield, Edward H (2006) Pathogenesis of tumor-associated syringomyelia demonstrated by peritumoral contrast material leakage. Case illustration. J Neurosurg Spine 4:426

Pluta, Ryszard M; Oldfield, Edward H (2006) Sodium nitrite as a therapeutic agent for central nervous system diseases. Surg Neurol 66:5-7; discussion 8-10

Walbridge, Stuart; Murad, Gregory J A; Heiss, John D et al. (2006) Technique for enhanced accuracy and reliability in non-human primate stereotaxy. J Neurosci Methods 156:310-3

Pluta, Ryszard M (2006) Dysfunction of nitric oxide synthases as a cause and therapeutic target in delayed cerebral vasospasm after SAH. Neurol Res 28:730-7

Pluta, Ryszard M (2005) Delayed cerebral vasospasm and nitric oxide: review, new hypothesis, and proposed treatment. Pharmacol Ther 105:23-56

Pluta, Ryszard M; Jung, Carla S; Harvey-White, Judith et al. (2005) In vitro and in vivo effects of probucol on hydrolysis of asymmetric dimethyl L-arginine and vasospasm in primates. J Neurosurg 103:731-8

Pluta, Ryszard M; Dejam, Andre; Grimes, George et al. (2005) Nitrite infusions to prevent delayed cerebral vasospasm in a primate model of subarachnoid hemorrhage. JAMA 293:1477-84

Lonser, Russell R; Vortmeyer, Alexander O; Butman, John A et al. (2005) Edema is a precursor to central nervous system peritumoral cyst formation. Ann Neurol 58:392-9

Tender, Gabriel C; Vortmeyer, Alexander O; Oldfield, Edward H (2005) Spinal intradural arteriovenous fistulas acquired in late adulthood: absent spinal venous drainage in pathogenesis and pathophysiology. Report of two cases. J Neurosurg Spine 3:488-94