What is William's theory of the pathophysiology of syringomyelia?

Updated: Nov 10, 2017
  • Author: Hassan Ahmad Hassan Al-Shatoury, MD, PhD, MHPE; Chief Editor: Selim R Benbadis, MD  more...
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This theory proposes that syrinx development, particularly in patients with Chiari malformation, follows a differential between intracranial pressure and spinal pressure caused by a valvelike action at the foramen magnum. [4] The increase in subarachnoid fluid pressure from increased venous pressure during coughing or Valsalva maneuvers is localized to the intracranial compartment.

The hindbrain malformation prevents the increased CSF pressure from dissipating caudally. During Valsalva, a progressive increase in cisterna magna pressure occurs simultaneously with a decrease in spinal subarachnoid pressure. This craniospinal pressure gradient draws CSF caudally into the syrinx.

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