Patients often present with nonspecific neck pain resulting from neck sprains. Often Magnetic Resonance Imaging of the Cervical spine is advised. Specialist opinion is requested if an incidental finding is found on MR Imaging as shown below:
Syringomyelia is an etiologically diverse affliction caused by disturbance of normal cerebrospinal fluid flow dynamics.
Origin of the term: Syrinx was a Naiad fresh-water nymph who lived on the cold mountainsides of Arcadia. One day she was amourously pursued by the Greek god Pan, and fleeing from her chaser, she was barred by the river Ladon. She asked for assistance from her Sorores Liquidae (Watery Sisters), who transformed her into a hollow water reed. When the God’s frustrated breath blew over the river, it made a haunting sound. Pan cut the reeds to fashion the first set of pan pipes, which were thenceforth known as ‘Syrinx.’
Syringomyelia literally means ‘Cavity within the spinal cord’ and is typically a progressive chronic condition. The Syrinx is either a fluid-filled, gliosis-lined cavity within the spinal cord parenchyma or it is a focal dilatation of the central canal, in which case it is called hydromyelia. In everyday clinical practice, the term syringomyelia is commonly used for both conditions. Most lesions are located between C2 and T9, but they can descend down to the Conus medullaris, or extend upward into the Brainstem (i.e., Syringobulbia).
Spinal MRI shows a dilated cavity with the same intensity of CSF on T2-weighted imaging. A complete brain and spinal MRI with and without Gadolinium is needed to determine the primary pathology. No pathologies were found on these investigations.
This MRI finding suggests ‘Residual central canal’ which refers to a thin, fluid-filled structure within the spinal cord with no associated pathologies. This structure usually tapers at each end and likely represents a normal variant: a remnant of a central canal normally present in embryos. These are usually incidental findings on scans obtained for unrelated issues. The patients are usually neurologically normal as in our patient.