El uso habitual de la Resonancia Magnética (RM) como medio de diagnóstico ha facilitado la detección de pacientes con siringomielias cervicales asintomáticoso En los últimos años se han descrito algunas observaciones de asociación de una siringomielia con descenso amigdalar y un proceso expansivo intracraneal, preferentemente infratentorial (tumores o quistes).
Presentamos los datos clínico-radiológicos de dos pacientes con esta asociación. La primera, mujer de 26 años de edad, con un neurinoma del acústico y una cavidad cervical asintomática, desde C2 a D7; tras la extirpación del tumor, la RM confirmó la desaparición completa de la cavidad. La segunda, mujer de 40 años, portadora de un pequeño meningioma del seno cavernoso derecho, responsable de una diplopia persistente en los últimos dos años, y una cavidad cervical en C2C3; fue tratada con radiocirugía, mejorando notablemente la diplopia, sin sufrir modificaciones, como es lógico, en la cavidad siringomiélica.
Mientras que la localización y tamaño del tumor establecen en el primer caso una relación causal entre los tres procesos, las características de la segunda paciente orientan a un mero hallazgo incidental.
The routine use of the magnetic resonance (MR), as diagnostic method in patients with CNS diseases, has led to identify an increasing number of cases of asymptomatic syringomyelia. During the last years, several reports on the association of syringomyelia, tonsilIar herniation and intracranial space occupying lesions (cysts or tumors), mainly located in the posterior cranial fossa, have appeared in the literature.
We describe the clinical and radiological findings of two female patients with this association. The first case is a 26-year-old woman, with an acoustic schwannoma and an asymptomatic cervical cavity from C2 to D7; a cervical MR imaging, performed after surgery, showed a total resolution of the cavity. The second case is a 40-year-old woman with a two years history of a persistent diplopia; cranial MR imaging showed a small, cavernous sinus meningioma, tonsilIar herniation and a syringomyelic cavity in C2-C3. Diplopia improved after she was treated with radiosurgery, but without changes in the cervical syringomyelia imaging.
While, in the first case, a causal relationship between the localization and size of the tumor, and the presence of syringomyelia can be established, in the second patient the association is considered incidental.
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