ABSTRACT

Most syringomyelias occur in a congenital malformative context, with a late clinical expression. A secondary syringomyelia can occur after a spinal cord injury. Lower urinary tract dysfunction and spinal cord lesions may be suspected in patients with anorectal abnormalities: among 30 patients presenting with anorectal abnormalities, S. Taskinen et al. found four syringomyelias on systematic MRIs, with two normal on urodynamic evaluation and two neurogenic detrusor overactivity. The urinary signs are not specific most of the time, as they constitute a part of the sublesional syndrome syringomyelia, with an upper motor neuron bladder due to a suprasacral lesion. Acute urinary retention has been described as the first manifestation of syringomyelia and can possibly be triggered by a well-defined factor-the Valsalva maneuver-which would acutely create increased pressure within the intraspinal space and the syrinx, or a pharmacologic side-effect of cyproheptadine.