Syrinx size and duration of symptoms predict the pace of progressive @entity602 : retrospective analysis of 103 unoperated cases with @entity600 and XXXX .

@entity1 @entity1644 @entity66 @entity602 @entity600 @entity51 @entity891 @entity76
OBJECTIVE: the clinical course of @entity1644 associated with craniocervical @entity66 is variable. About half of the unoperated @entity1 have benign course. This is difficult to explain on the basis of the present pathogenetic theories. Therefore, to understand the mechanism of syrinx progression better, we studied the value of syrinx size, syrinx morphology, and the syrinx/spinal cord size ratio in predicting the rate of progression and the severity of @entity602 in these @entity1 . METHODS: 103 adult @entity1 with @entity1644 associated with Chiari 1 @entity600 and/or radiographic signs of underdeveloped posterior cranial fossa were clinically and MRI examined. @entity1 were subdivided according to the type of disease progression. Severity of @entity51 , and MRI features (the extent of @entity76 , anteroposterior diameter of cavities, the spinal cord and cyst/cord ratio and the shape of cavities) were measured. RESULTS: a significant relationship was found between the mid-sagittal diameter of the syrinxes and the type of disease course; @entity1 with short duration and rapid progression had the largest diameters of cavities, whereas @entity1 with longer duration as well as with slow rate of progression had smaller diameters (chi(2)=28.90, P<0.05; chi(2)=29.89, P<0.01; r=-0.24, P<0.05). In addition, a correlation was found between the anteroposterior diameter of the spinal cord and cyst/cord ratio and the disease duration (r=0.52, P<0.05 and r=0.48, P<0.05, respectively). CONCLUSIONS: the initial years for the development of symptomatic @entity1644 associated with CCJ malformations are characterized by relatively rapid clinical progression accompanied with distended cavities. In the later periods of unoperated @entity1644 , some @entity1 show delay in the progress of syrinxes accompanied with @entity891 , probably either due to a spontaneous formation of drainage between the syrinx and the subarachnoidal space, or due to the restoration of abnormal CSF dynamics at the CCJ level.
