CSF pulsations within nonneoplastic spinal cord cysts

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Abstract
Because of its sensitivity to fluid motion, MR imaging was used to investigate fluid dynamics in syringomyelia. Three major findings characterized syringomyelia: pulsatile fluid in cysts, nonpulsatile fluid in cysts, and damaged cord tissue. The fluid in preoperative syrinx cavities pulsated in a fashion similar to subarachnoid CSF. Pulsation was more prominent in large cysts but was also seen in small cysts. Nonpulsatile cysts were generally of smaller diameter, were shorter in length, and often were single; they could, however, coexist with pulsatile cysts. Nonpulsatile cysts had etiologies similar to those of pulsatile cysts: Chiari malformation, trauma, and unknown. Damaged cord, characterized by abnormal high signal on T2-weighted sequences, was seen in 15 of 16 patients and could be either focal or diffuse but was always adjacent to syrinx cavities. Postsurgical MR scans had a lower incidence of pulsatile cysts. In five patients with both pre- and postoperative MR scans, shunting of the cyst reduced...