An Uncommon Case of Post-Traumatic Syringobulbia: A Case Report
DOI:
https://doi.org/10.51200/bjms.v16i.3754Keywords:
syringomyelia, syringobulbia, spinal cord injury, paraplegiaAbstract
Background and aim: Syringobulbia is a rare progressive neurological condition characterised by the presence of syrinx or an elongated fluid-filled cavity in the brainstem with multiple possible underlying aetiologies. However, to date, only a few cases of syringobulbia presenting as a late complication of post-traumatic syringomyelia (PTS) have been reported. Methods: We present a case of a 26-year-old morbidly obese gentleman with T4 AIS C incomplete spinal cord injury following T7 burst fracture 2 years prior requiring spinal instrumentation. He then experienced implant failure 1 year later, necessitating implant removal. Subsequently, he reported worsening back pain and neurology deterioration over his left upper and lower limb. In addition to that, pain and muscle spasms over the left upper limb extending up to the left side of his neck, face, and head warranted a repeat imaging of the brain and spinal cord. Magnetic resonance imaging (MRI) revealed syringobulbia predominantly affecting the left side of the medulla oblongata with extensive syringomyelia originating from the C1 to T12 vertebral level. Moreover, the old T7 fracture site remained malunited. Results: Despite a successful second spinal decompressive surgery and combined rehabilitation, there was no neurological recovery. However, the patient described significant improvement in pain and spasms. Conclusion: PTS complicated with syringobulbia, although rare, is one of the causes of the delayed-onset neurological deterioration in spinal cord injured patients. It might be a diagnostic dilemma as some cases exhibit atypical presentations and mimic the pre-existing neurological deficit. Syrinx formation due to alteration of subarachnoid cerebrospinal fluid (CSF) flow in post-traumatic spinal deformity might benefit from decompressive surgery, avoiding the need for intradural shunt placement, coupled with medication and physical therapy. Even though there was no neurological recovery, symptomatic alleviation of neuropathic pain and spasm improved quality of life.
Downloads
Published
How to Cite
Issue
Section
License
Borneo Journal of Medical Sciences
Copyright transfer and contributions agreement to publish in Borneo Journal of Medical Sciences (BJMS)
Transfer our author right to Borneo Journal of Medical Sciences (BJMS Publishers) along with title, interest in article without any limitations. The Journal shall own the work, including 1) copyright; 2) the right to grant permission to republish the article in whole or in part, with or without fee; 3) the right to produce preprints or reprints and translate into languages other than English for sale or free distribution; and 4) the right for electronic/visual reproduction, electronic storage and to republish the work in a collection of articles in any other mechanical or electronic format or printed publications.
We, the authors certify to participate sufficiently in the intellectual content, conception and design of this work or the analysis and interpretation of the data (when applicable), as well as the writing of the manuscript, to take public responsibility for it and have agreed to have our name listed as a contributor. We believe the manuscript represents valid work. Neither this manuscript nor one with substantially similar content under our authorship has been published or is being considered for publication elsewhere, except as described in the covering letter. Any such involvement, publishers of BJMS are not responsible and the authors are held for any untoward practices if any. Any other reproduction of the said article requires the permission from the publisher.
Authors also state that, the work is original and is not infringing with the rights of others and copyrights. Author also further declares that, each co-author have contributed significantly and have accepted to be co-authors for their significant contribution for the work.
We certify that all the data collected during the study is presented in this manuscript and no data from the study has been or will be published separately. We attest that, if requested by the editors, we will provide the data/information or will cooperate fully in obtaining and providing the data/information on which the manuscript is based, for examination by the editors or their assignees.
We give the rights to the corresponding author to make necessary changes as per the request of the journal, do the rest of the correspondence on our behalf and he/she will act as the guarantor for the manuscript on our behalf. All persons who have made substantial contributions to the work reported in the manuscript, but who are not contributors, are named in the Acknowledgment and have given us their written permission to be named. If we do not include an Acknowledgment that means we have not received substantial contributions from non-contributors and no contributor has been omitted.
Total Views: 247
| 
Total Downloads: 152
1.png){kind=logo}
