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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2024; 43(01): e1-e6
DOI: 10.1055/s-0043-1774746
Original Article

Syringomyelia: Retrospective Analysis of 30 Surgically Treated Patients from the Northeast of Brazil

Siringomielia: Análise retrospectiva de 30 casos operados no nordeste brasileiro
Bruna Lisboa do Vale 
1   Discipline of Neurosurgery, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
,
Maurus Marques de Almeida Holanda
2   Discipline of Neurology, Department of Internal Medicine, Medical Sciences Center, Universidade Federal da Paraíba, João Pessoa, PB, Brazil
,
Marcelo Moraes Valença
3   Neurosurgery Unit, Department of Neuropsychiatry, Health Sciences Center, Universidade Federal de Pernambuco, Recife, PE, Brazil
,
Severino Aires de Araújo Neto
4   Discipline of Radiology, Department of Internal Medicine, Medical Pessoa, PB, Brazil
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Abstract

Introduction Syringomyelia is a chronic disease characterized by the presence of intramedullary cavity. Chiari malformation (CM) and basilar impression (BI) are conditions usually associated with syringomyelia. Its prevalence has wide geographical variation, being higher in the Northeast of Brazil, making it relevant to study the subject in this region.

Objective To analyze the frequency of signs, symptoms, and surgical aspects observed in patients undergoing decompressive treatment.

Methods We performed a retrospective analysis of the medical records of patients diagnosed with syringomyelia who received decompressive surgical treatment in various hospitals in João Pessoa, Paraíba, between 1994 and 2021.

Results Thirty patients were analyzed. Twenty-nine (96.7%) presented CM and 27 (90.0%) also presented BI. A wide variety of symptoms was found, with significant prevalence of muscle weakness, neck pain, and headache. Brevicollis, a finding considered typical of the Northeastern region and associated with craniocervical junction malformations, was present in 66.7%. The surgical technique used in 90% of patients was similar. Fourteen (46.7%) patients presented difficult craniocervical junction and 4 (13.3%) had occipital bone assimilation. Eighteen (60.0%) presented thickening of the arachnoid membrane. Postoperatively, there was clinical improvement in 21 patients (70%).

Conclusions The sample majorly had CM and BI associated with syringomyelia. High prevalence of signs and symptoms related to the Brazilian northeastern phenotype was also found. Syringomyelia, therefore, has peculiarities in the population of the Northeast of Brazil that, when described, allow better understanding of the pathology in this group.

Resumo

Introdução Siringomielia é uma enfermidade crônica caracterizada pela presença de cavidade intramedular. Costuma vir associada a condições como malformação de Chiari (MC) e impressão basilar (IB). Sua prevalência tem grande variação geográfica, sendo maior no nordeste brasileiro, o que torna relevantes estudos sobre o tema nessa região.

Objetivo Analisar a frequência de sinais, sintomas e aspectos cirúrgicos observados em pacientes submetidos a tratamento descompressivo.

Método Foi realizada análise retrospectiva das informações contidas nos prontuários de pacientes diagnosticados com siringomielia submetidos a tratamento cirúrgico descompressivo em vários hospitais de João Pessoa, Paraíba, entre 1994 e 2021.

Resultados Foram analisados 30 pacientes, dos quais 29 (96,7%) apresentaram MC associada e 27 (90,0%) também tinham IB. Houve grande variedade de sintomas, com importante prevalência de fraqueza muscular, cervicalgia e cefaleia. Brevicolia, um achado considerado típico do nordestino e associado a malformações da junção craniocervical, esteve presente em 66,7% dos pacientes. A técnica cirúrgica utilizada em 90% dos pacientes foi semelhante. Quatorze (46,7%) pacientes apresentaram junção crânio-cervical difícil; e quatro (13,3%) apresentaram assimilação do osso occipital. Dezoito (60,0%) apresentaram espessamento da membrana aracnoide. No pós-operatório, houve melhora clínica em 21 pacientes (70%).

Conclusão A expressiva maioria da amostra possuía MC e IB associadas à siringomielia. Nota-se também grande prevalência de sinais e sintomas relacionados ao fenótipo nordestino. A siringomielia, portanto, possui peculiaridades na população do Nordeste brasileiro que, ao serem descritas, permitem a melhor compreensão da patologia nesse perfil de pacientes.

Keywords

craniocervical junction malformations - syringomyelia - Chiari malformation - basilar impression - surgery

Palavras-chave

malformações da junção craniocervical - siringomielia - malformação de Chiari - impressão basilar - cirurgia

Ethics Standards

This research was based on secondary data, ensuring privacy, confidentiality, and the non-use of information to the detriment of the subject, in accordance with Resolution 580/18 of the National Health Council, which establishes the ethical principles of research in human beings. The study was approved by the ethics committee of Hospital Universitário Lauro Wanderley.




Publication History

Received: 09 August 2022

Accepted: 07 March 2023

Article published online:
18 October 2023

© 2023. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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