Three cases of communicating syringomyelia secondary to midbrain gliomas

Abstract

There are many reports of cases in which syringomyelia has been associated with intracranial tumors. Such reports have been prompted by the rarity of the combination, and often by the belief that they shed light on the pathogenesis of syringomyelia. An extensive review is given by Poser (1956), and a reasonable discussion is found in Barnett et al. (1973). The different conclusions drawn by various authors serve to illustrate the complexity of the problems. In the cases here reported, there was a clear temporal sequence of events followed by full pathologic examination. A probable succession of the causative factors is suggested; the time course of the 3 cases is summarised in a table; All tumors were midbrain gliomas. In each case high pressure symptoms were followed by visual disturbance and the onset of symptoms sumptoms before death. All patients had hydrocephalus. In one case with concomitant syringobulbia, the syrinx appeared to be due to CSF communicating with the cord cavity through the tissues of the brain stem. In the other cases the communication between the CSF pathways and the syrinx was at the usual site, through the central canal at the obex.