What is Hydromyelia?
Hydromyelia is a medical condition that involves widening of the intraspinal cavity or is a marked dilatation of the central spinal canal. The central canal of the spinal column is the main area of affectation that results to increased pressure due to fluid accumulation.
Somehow, this condition is confused with syringomyelia or both are simply compared with each other. However, the following conditions are different from each other but are somehow similar in some ways. The condition is said to be associated with the birth defects known as Chiari Malformation II and the complex congenital brain malformation, Dandy-Walker syndrome. Other closely related conditions are Klippel-Feil syndrome and neuropathic joint disease.
Some patients may be asymptomatic but are noted to be occurring in isolated cases. Patients suffering from hydromyelia would prominently manifest the following symptoms:
- Feelings of numbness in the neck. The extreme pain or discomfort is contributed by such condition and feeling of heaviness is the usual complaint among the affected.
- Tingling sensation is felt which is indicative of parasthesia.
- Sensory loss arises.
- Chronic headaches.
- Difficulty in ambulation and walking. This may be due to the paralysis of the legs.
- Bowel and bladder incontinence.
- Increased intracranial pressure or simply intracranial hypertension.
- Visual changes and disturbances.
- Speech difficulties and problems may arise.
Hydromyelia is idiopathic in cause. The cause of such spinal canal condition is not fully understood as complications and a number of factors are considered for it. The following are the associated conditions of hydromyelia:
- Spinal cord injury.
- Spinal injury that is followed by infection.
- Mass or tumor formation in the spinal cord. This can interfere with the proper spinal fluid flow.
- Underlying conditions such as Arnold Chiari malformation II, etc.
- Some genetic factors are proposed to play in the development of hydromyelia. However, no clear support is found for hydromyelia.
Diagnosis for Hydromyelia
Diagnosis for hydromyelia is attained through neurological examination and imaging studies involving the nervous system. Through a neurological exam, the patient will show loss of sensation of the upper extremities, balance problems, weakness, changes in gait and difficulty in walking, and altered reflexes. With these symptoms noted and found positively present in the patient, hydromyelia diagnosis can be supported.
An electromyography is also performed in order to assess the client’s musculoskeletal state. This will also assesses the muscle strength and speed in response from nerve stimulations. However, one examination is considered as the main diagnostic tool for hydromyelia; MRI scan or magnetic resonance imaging scan/test, specifically CINE MRI.
This exam will help show the current flow of cerebrospinal fluid in the spinal cord. This is also performed in the same manner with the traditional MRI scan; however there is an additional heart rate analysis during the scan. The heart beats will be a sort of guide to the flow of the CSF. The MRI machine will take images that typically show the sufficiency of CSF flow.
Treatment for Hydromyelia
Hydromyelia is a medical condition that needs prompt treatment as this can cause for chronic symptoms and possible permanent disability when not properly treated. In light to that, we should consult a doctor’s advice when problems of the spinal cord is suspected or whenever a spinal cord injury is acquired. Proper treatment is basically attained when we consult a doctor and make sure we follow their advice.
Surgical intervention is considered the promising treatment intervention for hydromyelia. In surgery, the patient shall attain correction from the improper CSF flow thus lessening the pressure in the spinal cord. Decompression is also performed as this helps reduce spinal cord injury from the increased CSF flow. Placing of a shunt is an intervention that helps reduce intracranial pressure or hypertension.
After the surgical intervention, it is also necessary to subject the patient to a physical therapy. Occupational therapy is also recommended as to help regain one’s strength and usual mobility. Management of the patient’s chronic pain is done. Prescription drugs are provided and can help soothe the discomfort.
Even though treatment is provided accordingly, one cannot expect immediately that the condition has a good prognosis. With this type of condition involving the spinal cord, permanent damage or somehow temporary relief is attained from the said interventions above. Because of such instance, care among the family members and attention is necessary to help the client recuperate from hydromyelia.
Family support can provide a long way of recuperation as this can help boost the patient’s self esteem and will to survive from the dreaded spinal cord condition. Since there are a number of symptoms of hydromyelia, the family’s primary role is to assist the patient in times of need but should also be taught on independency in order to attain, if not full, recovery.
Hydromyelia vs. Syringomyelia
Both hydromyelia and syringomyelia involve the collection or pooling of fluid in the spinal canal/cord. These two conditions are usually compared as both conditions involve the same mechanism which ends up putting great pressure to the spinal cord. The significant difference with the two spinal cord conditions are its area of involvement. In hydromyelia, the abnormal pressure is most directed to the cavity area that connects the fourth ventricle of the brain. While in syringomyelia, the condition primarily affects the adults that involve closed cavity or a cystic formation within the spinal cord. The condition primarily affects those adults who have Chiari Malformation type 1 and those who suffered from any form of spinal cord trauma.
The cyst involved in syringomyelia results to permanent damage as it has the very bad tendency of destroying the structure of our spinal cord. This cyst is called syrinx, which is very much easy to see and indentify under a CT scan. In hydromyelia, the basic spinal fluid flow is being assessed in order to identify it. When it comes to syringomyelia, identification of a syrinx in an enclosed cavity helps in the diagnosis.
Basically, the two conditions mimic each other but should not be associated in a frequent manner as these two are quite different in terms.