Syringobulbia extending to the basal ganglia.

ogy to a craniocervical trauma suffered 6 years earlier. During the last months she began to complain of dorsal back pain and urgency of micturition. Neurologic examination revealed a left hemiparesis without facial involvement, brisk deep-tendon reflexes , and left Ba­ binski sign . Cranial nerves were not impaired and sensation . was normal. X-ray examination and CT of the cervical spine showed a mild widening of the cervical canal and an ununited C1 posterior arch. Brain CT examination and myelography were performed (Figs. 1 and 2) , and a microsurgical approach through a T2 median laminec­ tomy was carried out 1 month later. Myelotomy showed a high­ pressure, fluid-filled cavity within a well-preserved cord parenchyma. Clear CSF flowed from the cavity and continued to flow during the whole procedure. The horizontal branches of a T-shaped silicone rubber catheter were introduced into the cavity in a cephalad and caudad direction , and iopamidol 200 , 1.5 ml , was injected through the vertical branch to determine the whole extent of the syrinx. X-ray examination showed opacification of the left lateral ventricle, the head being at a lower level with respect to the dorsal region . The T-tube vertical branch was then introduced caudad to drain into the thoracic subarachnoid space. Tomography was performed immediately after surgery (Fig . 3) . CT scans (Fig . 4) showed that in the medulla the cavity was situated ventrally, in the region of the left pyramid, and in