SPINAL SUBARACHNOID SPACE TRABECULATION DEFECTS AND THEIR CLINICAL-SURGICAL IMPORTANCE IN SYRINGOMIELIA

Syringomyelia, manifests as an intradural fluid collection, forming a cavity that compresses and elongates the neural tissue in a centrifuge manner evolving towards sensitive-motor impairment of the patient, associated to different etiologies whose common point involves the persistent alteration of the circulation dynamics of CSF according to classic postulates. Among them are spinal arachnoid cysts and webs, infrequent as isolated disorders, even more as a joint process. We present an illustrative case of a 48 years old feminine patient, with syringomielia associated to a spinal intradural arachnoid cyst, with an arachnoid web proximal and caudal to the said lesion, with an excellent evolution after drainage and exeresis of the cyst and webs. Being infrequent, spinal arachnoid cysts arachnoid webs are a diagnostic possibility in cases of clinical myelopathy whose evaluation reveals the presence and of nonsyndromic syringomyelia, and given the good postoperative evolution they usually present, is imperative to rule them out by means of a detailed review of the image studies with the possible presence of the recently described "scalpel sign", because their resolution can greatly help the patient's outcome and prognosis and even achieve an almost total resolution of the syringomyelia. The former postulates on the formation of these cavities have been modified thanks to the appearance of the intramedullary pulse pressure theory, which is reviewed and we suggest associating the distal pressure blocks importance on the formation and perpetuation of the syrinx by Venturi effect.