Abnormal growth of a fluid-filled chamber in the medulla and, in most cases, the spinal cord characterizes the condition known as syringobulbia, which affects the lower brainstem. The brainstem is a region located deep within the cervical spinal cord and cerebral hemispheres. Similar to respiration, it regulates the body’s involuntary functions. It holds multiple command hubs responsible for managing functions like swallowing and vasomotor regulation. The symptoms and indications are mostly brought on by malfunction in the central portion of the spinal cord.
This disorder typically manifests as a slit-like opening in the lower brainstem, which can impact one or more cranial nerves and result in a variety of facial palsies. This condition is closely related to syringomyelia, in which the syrinx is restricted to the spinal cord, and the Chiari I malformation.
A malfunction in the core part of the spinal cord is the root cause of the sign and symptoms. Clefts and cavities (syrinxes) are the two most common causes of damage. Patients often exhibit differently depending on the severity of their condition and where their syrinx is located in the medulla.
In addition to oscillopsia, diplopia, or vertigo, the most typical symptoms of syringobulbia are an absence of pain in response to unintentional burns, tingling or numbness in the hands, pain in the neck and arms, stiffness in the legs, and headaches. Low-level brainstem dysfunction is also visible on physical examination.
In its early stages, syringobulbia mostly shows some of the following signs:
- One of the signs of Syringbulbia is a loss of sensation in the face region.
- Rarely, individuals with syringobulbia show signs of nausea and vomiting.
- In some circumstances, Syringobulbia patients also experience tinnitus.
- Tongue muscle fibrillation.
- Gait instability.
- Vocal hoarseness.
There is no recognized trigger for Syringobulbia. In most cases, the condition is manifested at birth. The specific etiology of Syringobulbia is currently unknown, but when this ailment manifests, cerebrospinal fluid builds up around the spinal cord, generating these fluid-filled cysts. Syringobulbia is potentially caused by a spinal cord malignancy. Some research suggests that spinal cord tethering also contributes to this illness.
Syringobulbia is a rare condition that occurs as a result of a delayed progression of Syringomyelia into the medulla. Small posterior fossa, birth trauma resulting in hematomyelia, or arachnoid scarring are a few factors that need to take into account. A congenital abnormality, trauma, or tumor growth are frequently the causes of syringobulbia. The specific cause is unknown, however, it is mostly related to a broadening of the spinal cord’s central canal.
The physician mostly begins by obtaining a thorough history of the duration of the symptoms. Following this, the doctor does a physical examination in search of obvious signs of Syringobulbia. An MRI of the head and spine is performed if syringobulbia is suspected; this allows the doctor to see any Cerebrospinal fluid buildup or cavities filled with fluid near the spinal cord. A diagnosis of syringobulbia is nearly always confirmed by an MRI showing the hollow filled with fluid.
Using diversion tubes or shunts, syringobulbia is almost always treated surgically. Surgery for syringobulbia takes a variety of forms, however, it is typically combined with syringomyelia therapy.
Surgeons remove cyst fluid by inserting a shunt, which is a tube and valve, into the cyst and routing the other end to another location in the body, most commonly the abdomen.
Removal of a tumor or other abnormal growth that is blocking Cerebrospinal fluid flow helps restore normal CSF (Cerebrospinal fluid) flow and allows cyst fluid to escape.
Syringobulbia vs Syringomyelia
Syringomyelia causes cavitation of the spinal cord, which disrupts the anterior commissure’s pain and temperature neurons. If the brainstem is affected, it is referred to as syringobulbia (usually the medulla).
syringobulbia is cavitation of the medulla and syringomyelia, which affects the central spinal cord, are uncommon conditions. Most of the time, these conditions are caused by birth defects like Chiari malformations, tumors, or injuries to the spinal cord. The disease progresses from small sensory abnormalities to weakness, wasting, and, in syringobulbia, respiratory compromise and death. To treat the syrinx cavity surgically, it is necessary to drain or decompress it and divert fluid to the peritoneal cavity or subarachnoid region.