{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T16:06:23Z","timestamp":1776096383450,"version":"3.50.1"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"11","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,3,16]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Posttraumatic syringomyelia (PTS) refers to an elongated, intramedullary spinal cyst, representing a spectrum of severity and a variable interval after spinal cord injury (SCI). It typically presents with worsening motor and\/or sensory function after a period of relative symptom stability following injury. The worsening ascends rostrally to include spinal cord levels previously intact above the level of injury. Rarely, PTS cavities extend rostrally to brainstem levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The case presented demonstrates nearly the full spectrum of features associated with PTS. The onset of worsening occurred relatively early, about 1 year after motor complete SCI at the T2\u20133 level. The delayed onset of worsening symptoms of the PTS included asymmetric sensory and motor deficits that extended rostral to the upper extremities, face, and swallowing, and caudal to include back pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>The authors highlight key features of PTS, including 1) bilateral ascending expansile syrinx in the peridorsal horn gray matter, 2) medullary extension with trigeminal nucleus symptoms consistent with syringobulbia, and 3) evidence of spontaneous remission or collapsing cord sign. Additionally, risk factors for early PTS are discussed, including motor complete thoracic SCI with spinal stenosis on MRI. Operative management included hardware removal, laminectomy, spinal cord untethering with wide syringostomy, and duraplasty.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25797\">https:\/\/thejns.org\/doi\/10.3171\/CASE25797<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25797","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T13:13:06Z","timestamp":1773925986000},"source":"Crossref","is-referenced-by-count":0,"title":["Posttraumatic syrinx resulting in syringomyelia and syringobulbia: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"given":"Nicholas","family":"Dietz","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Louisville, Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aashka","family":"Sheth","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Louisville, Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4118-4638","authenticated-orcid":true,"given":"Camilo","family":"Castillo","sequence":"additional","affiliation":[{"name":"Division of Physical Medicine and Rehabilitation, University of Louisville, Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Freeman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Louisville, Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haring","family":"Nauta","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Louisville, Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"bib1","series-title":"Nat Rev Dis Primers","article-title":"Traumatic spinal cord injury","volume":"3","author":"Ahuja","year":"2017","unstructured":"Ahuja CSWilson JRNori STraumatic spinal cord injury. Nat Rev Dis Primers. 2017;3:17018. doi:10.1038\/nrdp.2017.18"},{"issue":"10","key":"bib2","series-title":"Acta Neurochir (Wien)","first-page":"2541","article-title":"Treatment of posttraumatic syringomyelia: evidence from a systematic review","volume":"162","author":"Kleindienst","year":"2020","unstructured":"Kleindienst ALaut FMRoeckelein VBuchfelder MDodoo-Schittko F.Treatment of posttraumatic syringomyelia: evidence from a systematic review. Acta Neurochir (Wien). 2020;162(10):2541-2556. doi:10.1007\/s00701-020-04529-w"},{"issue":"1","key":"bib3","series-title":"J Spinal Cord Med","first-page":"155","article-title":"Rapid progression of acute cervical syringomyelia: a case report of delayed complications following spinal cord injury","volume":"45","author":"Yuan","year":"2022","unstructured":"Yuan CGuan JJian F.Rapid progression of acute cervical syringomyelia: a case report of delayed complications following spinal cord injury. J Spinal Cord Med. 2022;45(1):155-159. doi:10.1080\/10790268.2020.1733336"},{"issue":"1","key":"bib4","series-title":"J Med Case Rep","first-page":"223","article-title":"Development of pre-syrinx state and syringomyelia following a minor injury: a case report","volume":"14","author":"Kleindienst","year":"2020","unstructured":"Kleindienst AEngelhorn TRoeckelein VBuchfelder M.Development of pre-syrinx state and syringomyelia following a minor injury: a case report. J Med Case Rep. 2020;14(1):223. doi:10.1186\/s13256-020-02568-6"},{"issue":"6","key":"bib5","series-title":"Spinal Cord","first-page":"463","article-title":"The characteristics of posttraumatic syringomyelia","volume":"54","author":"Krebs","year":"2016","unstructured":"Krebs JKoch HGHartmann KFrotzler A.The characteristics of posttraumatic syringomyelia. Spinal Cord. 2016;54(6):463-466. doi:10.1038\/sc.2015.218"},{"issue":"3","key":"bib6","series-title":"J Neurosurg Spine","first-page":"199","article-title":"Treatment of posttraumatic syringomyelia","volume":"17","author":"Klekamp","year":"2012","unstructured":"Klekamp J.Treatment of posttraumatic syringomyelia. J Neurosurg Spine. 2012;17(3):199-211. doi:10.3171\/2012.5.SPINE11904"},{"issue":"12","key":"bib7","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1132","article-title":"Syringobulbia: a surgical appraisal","volume":"55","author":"Morgan","year":"1992","unstructured":"Morgan DWilliams B.Syringobulbia: a surgical appraisal. J Neurol Neurosurg Psychiatry. 1992;55(12):1132-1141. doi:10.1136\/jnnp.55.12.1132"},{"issue":"17","key":"bib8","series-title":"Spine (Phila Pa 1976)","first-page":"E399","article-title":"The role of acute decompression and restoration of spinal alignment in the prevention of post-traumatic syringomyelia: case report and review of recent literature","volume":"26","author":"Bains","year":"2001","unstructured":"Bains RSAlthausen PLGitlin GNGupta MCBenson DR.The role of acute decompression and restoration of spinal alignment in the prevention of post-traumatic syringomyelia: case report and review of recent literature. Spine (Phila Pa 1976). 2001;26(17):E399-E402. doi:10.1097\/00007632-200109010-00028"},{"issue":"10","key":"bib9","series-title":"No Shinkei Geka","first-page":"895","article-title":"Posttraumatic syringomyelia developing soon after spinal cord injury. A case report","volume":"36","author":"Yoshimura","year":"2008","unstructured":"Yoshimura KSasaki MMorris SAbekura MYoshimine T.Posttraumatic syringomyelia developing soon after spinal cord injury. A case report. Article in Japanese. No Shinkei Geka. 2008;36(10):895-900."},{"issue":"5","key":"bib10","series-title":"Eur Neurol","first-page":"378","article-title":"Spontaneous collapse of posttraumatic syringomyelia: serial magnetic resonance imaging","volume":"33","author":"Birbamer","year":"1993","unstructured":"Birbamer GBuchberger WFelber SPosch ARussegger L.Spontaneous collapse of posttraumatic syringomyelia: serial magnetic resonance imaging. Eur Neurol. 1993;33(5):378-381. doi:10.1159\/000116975"},{"key":"bib11","series-title":"Syringomyelia. Vol 1. Major Problems in Neurology","volume":"xv","author":"Barnett","year":"1973:","unstructured":"Barnett HJMFoster JBHudgson P.Syringomyelia. Vol 1. Major Problems in Neurology. Saunders; 1973:xv."},{"issue":"1","key":"bib12","series-title":"Pediatr Neurosurg","first-page":"43","article-title":"Spontaneous resolution of a cervicothoracic syrinx in a child. Case report and review of the literature","volume":"30","author":"Avellino","year":"1999","unstructured":"Avellino AMBritz GWMcDowell JRShaw DWEllenbogen RGRoberts TS.Spontaneous resolution of a cervicothoracic syrinx in a child. Case report and review of the literature. Pediatr Neurosurg. 1999;30(1):43-46. doi:10.1159\/000028760"},{"issue":"1","key":"bib13","series-title":"Acta Neurochir (Wien)","first-page":"83","article-title":"Cordectomy for post-traumatic syringomyelia","volume":"150","author":"Kasai","year":"2008","unstructured":"Kasai YKawakita EMorishita KUchida A.Cordectomy for post-traumatic syringomyelia. Acta Neurochir (Wien). 2008;150(1):83-86. doi:10.1007\/s00701-007-1421-9"},{"issue":"1","key":"bib14","series-title":"J Neurosurg Pediatr","first-page":"52","article-title":"Syringobulbia in pediatric patients with Chiari malformation type I","volume":"22","author":"Menezes","year":"2018","unstructured":"Menezes AHGreenlee JDWDlouhy BJ.Syringobulbia in pediatric patients with Chiari malformation type I. J Neurosurg Pediatr. 2018;22(1):52-60. doi:10.3171\/2018.1.PEDS17472"},{"issue":"1","key":"bib15","series-title":"Spinal Cord Ser Cases","first-page":"15","article-title":"Silent post-traumatic syringomyelia and syringobulbia","volume":"6","author":"Scivoletto","year":"2020","unstructured":"Scivoletto GMasciullo MPichiorri FMolinari M.Silent post-traumatic syringomyelia and syringobulbia. Spinal Cord Ser Cases. 2020;6(1):15. doi:10.1038\/s41394-020-0264-y"},{"issue":"2","key":"bib16","series-title":"J Spinal Cord Med","first-page":"260","article-title":"Syringobulbia: a delayed complication following spinal cord injury\u2014case report","volume":"42","author":"Mousele","year":"2019","unstructured":"Mousele CGeorgiopoulos MConstantoyannis C.Syringobulbia: a delayed complication following spinal cord injury\u2014case report. J Spinal Cord Med. 2019;42(2):260-264. doi:10.1080\/10790268.2018.1439437"},{"issue":"4","key":"bib17","series-title":"NMC Case Rep J","first-page":"217","article-title":"Early development of syringomyelia after spinal cord injury: case report and review of the literature","volume":"7","author":"Miyao","year":"2020","unstructured":"Miyao YSasaki MTaketsuna SYokota CUmegaki M.Early development of syringomyelia after spinal cord injury: case report and review of the literature. NMC Case Rep J. 2020;7(4):217-221. doi:10.2176\/nmccrj.cr.2019-0297"},{"issue":"2","key":"bib18","series-title":"J Neurosurg","first-page":"149","article-title":"Outcome after surgical treatment of progressive posttraumatic cystic myelopathy","volume":"92","author":"Lee","year":"2000","unstructured":"Lee TTAlameda GJGromelski EBGreen BA.Outcome after surgical treatment of progressive posttraumatic cystic myelopathy. J Neurosurg. 2000;92(2)(suppl):149-154. doi:10.3171\/spi.2000.92.2.0149"},{"issue":"1","key":"bib19","series-title":"Arch Phys Med Rehabil","first-page":"102","article-title":"Early onset posttraumatic cystic myelopathy complicating spinal cord injury","volume":"75","author":"Yarkony","year":"1994","unstructured":"Yarkony GMSheffler LRSmith JChen DRayner SL.Early onset posttraumatic cystic myelopathy complicating spinal cord injury. Arch Phys Med Rehabil. 1994;75(1):102-105. doi:10.1016\/0003-9993(94)90345-X"},{"issue":"2","key":"bib20","series-title":"Evid Based Spine Care J","first-page":"116","article-title":"Persistent\/recurrent syringomyelia after Chiari decompression-natural history and management strategies: a systematic review","volume":"4","author":"Schuster","year":"2013","unstructured":"Schuster JMZhang FNorvell DCHermsmeyer JT.Persistent\/recurrent syringomyelia after Chiari decompression-natural history and management strategies: a systematic review. Evid Based Spine Care J. 2013;4(2):116-125. doi:10.1055\/s-0033-1357362"},{"key":"bib1","series-title":"Nat Rev Dis Primers","article-title":"Traumatic spinal cord injury","volume":"3","author":"Ahuja","year":"2017","unstructured":"Ahuja CSWilson JRNori STraumatic spinal cord injury. 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Spinal Cord. 2016;54(6):463-466. doi:10.1038\/sc.2015.218"},{"issue":"3","key":"bib6","series-title":"J Neurosurg Spine","first-page":"199","article-title":"Treatment of posttraumatic syringomyelia","volume":"17","author":"Klekamp","year":"2012","unstructured":"Klekamp J.Treatment of posttraumatic syringomyelia. J Neurosurg Spine. 2012;17(3):199-211. doi:10.3171\/2012.5.SPINE11904"},{"issue":"12","key":"bib7","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1132","article-title":"Syringobulbia: a surgical appraisal","volume":"55","author":"Morgan","year":"1992","unstructured":"Morgan DWilliams B.Syringobulbia: a surgical appraisal. J Neurol Neurosurg Psychiatry. 1992;55(12):1132-1141. doi:10.1136\/jnnp.55.12.1132"},{"issue":"17","key":"bib8","series-title":"Spine (Phila Pa 1976)","first-page":"E399","article-title":"The role of acute decompression and restoration of spinal alignment in the prevention of post-traumatic syringomyelia: case report and review of recent literature","volume":"26","author":"Bains","year":"2001","unstructured":"Bains RSAlthausen PLGitlin GNGupta MCBenson DR.The role of acute decompression and restoration of spinal alignment in the prevention of post-traumatic syringomyelia: case report and review of recent literature. Spine (Phila Pa 1976). 2001;26(17):E399-E402. doi:10.1097\/00007632-200109010-00028"},{"issue":"10","key":"bib9","series-title":"No Shinkei Geka","first-page":"895","article-title":"Posttraumatic syringomyelia developing soon after spinal cord injury. A case report","volume":"36","author":"Yoshimura","year":"2008","unstructured":"Yoshimura KSasaki MMorris SAbekura MYoshimine T.Posttraumatic syringomyelia developing soon after spinal cord injury. A case report. Article in Japanese. No Shinkei Geka. 2008;36(10):895-900."},{"issue":"5","key":"bib10","series-title":"Eur Neurol","first-page":"378","article-title":"Spontaneous collapse of posttraumatic syringomyelia: serial magnetic resonance imaging","volume":"33","author":"Birbamer","year":"1993","unstructured":"Birbamer GBuchberger WFelber SPosch ARussegger L.Spontaneous collapse of posttraumatic syringomyelia: serial magnetic resonance imaging. Eur Neurol. 1993;33(5):378-381. doi:10.1159\/000116975"},{"key":"bib11","series-title":"Syringomyelia. Vol 1. Major Problems in Neurology","volume":"xv","author":"Barnett","year":"1973:","unstructured":"Barnett HJMFoster JBHudgson P.Syringomyelia. Vol 1. Major Problems in Neurology. Saunders; 1973:xv."},{"issue":"1","key":"bib12","series-title":"Pediatr Neurosurg","first-page":"43","article-title":"Spontaneous resolution of a cervicothoracic syrinx in a child. Case report and review of the literature","volume":"30","author":"Avellino","year":"1999","unstructured":"Avellino AMBritz GWMcDowell JRShaw DWEllenbogen RGRoberts TS.Spontaneous resolution of a cervicothoracic syrinx in a child. Case report and review of the literature. Pediatr Neurosurg. 1999;30(1):43-46. doi:10.1159\/000028760"},{"issue":"1","key":"bib13","series-title":"Acta Neurochir (Wien)","first-page":"83","article-title":"Cordectomy for post-traumatic syringomyelia","volume":"150","author":"Kasai","year":"2008","unstructured":"Kasai YKawakita EMorishita KUchida A.Cordectomy for post-traumatic syringomyelia. Acta Neurochir (Wien). 2008;150(1):83-86. doi:10.1007\/s00701-007-1421-9"},{"issue":"1","key":"bib14","series-title":"J Neurosurg Pediatr","first-page":"52","article-title":"Syringobulbia in pediatric patients with Chiari malformation type I","volume":"22","author":"Menezes","year":"2018","unstructured":"Menezes AHGreenlee JDWDlouhy BJ.Syringobulbia in pediatric patients with Chiari malformation type I. J Neurosurg Pediatr. 2018;22(1):52-60. doi:10.3171\/2018.1.PEDS17472"},{"issue":"1","key":"bib15","series-title":"Spinal Cord Ser Cases","first-page":"15","article-title":"Silent post-traumatic syringomyelia and syringobulbia","volume":"6","author":"Scivoletto","year":"2020","unstructured":"Scivoletto GMasciullo MPichiorri FMolinari M.Silent post-traumatic syringomyelia and syringobulbia. 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