Void formation

Introduction Cavity formation refers to depressions or pores left in the original place after the necrotic or liquefied diseased material in the organ tissue is discharged. This condition is mainly seen in the case of tuberculosis, but also in the case of syringomyelia. Causes of tuberculosis cavity formation: tuberculosis is multiplied in the lung lesions, local lung tissue is damaged, and lesions form cheese necrosis. After the lesion is dissolved and liquefied through the bronchus, the necrotic material is coughed out from the bronchus, and air enters the cavity to form a cavity.

Cause

(1) Causes of tuberculosis cavity formation:

In the lung lesions, tuberculosis is multiplied, local lung tissue is damaged, and lesions form cheese necrosis. After the lesion is dissolved and liquefied through the bronchus, the necrotic material is coughed out from the bronchus, and air enters the cavity to form a cavity.

(2) Reasons for the formation of syringomyelia:

1. Greenfield emphasizes that syringomyelia is a tubular cavity in the spinal cord. It extends from the neck to many segments. It should be considered as different from the central cyst of the spinal cord. The empty water is more suitable for the latter. It is considered that the disease is the midline development of the spinal cord. As a result of the deformity, the cavity can be communicated with the central tube, and the hollow lining can be seen in the ependymal cells, and the intracapsular fluid is similar to CSF. Some people think that this disease is due to the proliferation of glial cells, and the central part of the necrosis forms a cavity.

2, congenital dysplasia generally considered syringomyelia is congenital dysplasia, because the disease is often accompanied by other congenital anomalies, such as: spinal cord fissure, hydrocephalus, etc., it is considered that syringomyelia is a congenital developmental defect.

3, cerebrospinal fluid dynamics theory Some people think that due to the congenital fourth ventricle outlet occlusion, cerebrospinal fluid circulation disorder, cerebrospinal fluid pulsating pressure constantly impacts the spinal cord central tube, resulting in the continuous expansion of the spinal cord central tube, eventually forming a hollow hole.

4, syringomyelia can be secondary to spinal cord trauma, spinal glioma, cystic lesions, vascular malformations, spinal arachnoiditis, myelitis with central softening and other diseases.

an examination

Related inspection

General radiography examination chest MRI chest CT examination

First, the diagnosis of tuberculosis cavity:

The most common sites are the two upper lobe, with some statistics accounting for about 70%, the lower leaves followed, and the middle (lingual) leaves the least. The lower lobes are often seen in the apex. Empty holes can be single or multiple. The voids appear as circular, circular, irregular shaped or honeycomb shaped light-transmissive areas on the X-ray. The small cavity can be only a few millimeters, the larger one can occupy a leaf lung or even the whole lung, usually 2 to 5 cm. The walls of the cavity are thick and thin, and the amount of cheese in the hole is different.

Second, the diagnosis of syringomyelia:

The disease is mostly in the middle and young age, and the course of disease is slow. Segmental dissociative superficial sensory disturbance, muscle atrophy, skin joint dystrophy, often accompanied by spinal deformity, arched foot and so on. Cerebrospinal fluid examination pressure and composition are mostly normal, when the cavity is large, it can also cause spinal canal obstruction, and the protein content of cerebrospinal fluid is increased. X-ray film can confirm the skeletal malformation. Magnetic resonance imaging (MRI) is the best diagnostic method for syringomyelia. It can not only show the location, shape and extent of the ridge, but also the related lesions (abnormality, Diagnosis of tumors, spinal stenosis, etc.)

Differential diagnosis

First, the tuberculosis cavity needs to be differentiated from the hollow tuberculosis.

Second, syringomyelia needs to be differentiated from the following symptoms.

1. Spinal cord tumors and brainstem tumors: Both extramedullary spinal cord and intramedullary tumors can cause localized muscular atrophy and segmental sensory disturbances. In tumor cases, astrocytoma or ependymoma in the gray matter of the spinal cord is secreted. The accumulation of proteinaceous fluid on the tumor, the diameter of the spinal cord is widened, the posterior column of the spine and the symptoms of the nervous system can be similar to syringomyelia, especially in the lower cervical spinal cord. However, the progression of tumor cases is faster, root pain is common, and nutritional disorders are rare. Increased protein in early cerebrospinal fluid can be distinguished from this disease by identifying CTMRI in difficult cases. Occurs in children and adolescents, with obvious cross-paralysis, short duration, rapid development, and increased intracranial pressure in the late stage.

2. Cervical vertebrae joint disease: Although there may be muscle atrophy of the upper limbs and segmental sensory disturbance, but no shallow sensory separation, root pain is more common, muscle atrophy is often lighter, generally no nutritional disorders, and the lesion level is obvious segmental Sensory dysfunction is a rare cervical radiograph, if necessary, myelography and cervical CT or MRI can help confirm the diagnosis.

3. Cervical ribs: It can cause localized atrophy of small muscles in the hand and evidence of sensory disturbance with or without subclavian artery compression. Because of the neck ribs often associated with syringomyelia, the diagnosis can be confused. However, the sensory disturbance caused by the neck rib is usually limited to the ulnar side of the hand and forearm. The tactile dysfunction is more severe than the pain dysfunction. The upper arm tendon reflex is not affected, and there is no long beam sign. It can also help to identify the cervical spine. Establish a diagnosis.

4. Syphilis: It can be suspected in two aspects of syringomyelia in rare proliferative dural sinusitis, there may be upper limb sensory disturbance atrophy and weakness and lower limb pyramidal tract sign, but myelography can show subarachnoid obstruction and disease course Progression is also more rapid than syringomyelia. The syphilis of the spinal cord can show signs of intramedullary tumors, but the progression of the disease is rapidly disrupted and the syphilis seropositive.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.