Abstract
Syringomyelia is a rare neurological condition in which a fluid-filled cavity (syrinx) has developed in the spinal canal or in the spinal parenchyma. An associated Arnold-Chiari malformation (common in patients with syringomyelia) may involve herniation of the cerebellum through the foramen magnum. The anesthetic plan should focus on not increasing the craniospinal pressure gradient, in order to prevent expansion of the syrinx, leading to spinal cord damage and/or increasing brain herniation. Neuraxial anesthesia, including both spinal and epidural, are reasonable options for cesarean delivery or labor analgesia in certain instances. When determining the optimal anesthetic plan, multiple factors, including the current intracranial pressure, the degree of CSF obstruction, the patient’s current neurological status, and the extent/level of the syrinx, should be considered. Because a wide spectrum of clinical symptoms exists in patients with syringomyelia and no anesthetic plan has been found to be superior for any mode of delivery, the preferences of the patient and practitioner should be weighed to determine a delivery plan that will optimize a favorable outcome.
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Sachs, A., Onye, A. (2018). Syringomyelia. In: Mankowitz, S. (eds) Consults in Obstetric Anesthesiology. Springer, Cham. https://doi.org/10.1007/978-3-319-59680-8_153
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DOI: https://doi.org/10.1007/978-3-319-59680-8_153
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