[Hydromyelia combined with hydrocephalus].

A case of hydromyelia (syringomyelia) combined with hydrocephalus is presented. The patient was a 17-year-old-boy. He was a admitted to our hospital because of disturbance of fine movement of the right hand. Neurological examinations showed right hemiparesis, right upper muscle atrophy and sensory dissociation of C1-T2 dermatomes. This dissociated sensory impairment gradually deteriorated. CT scan performed 3 and 6 hours after the intrathecal injection of metrizamide revealed an intramedullary syrinx extending between C1 and T4 vertebral levels and communicating with the 4th ventricle. Ventriculo-peritoneal shunt with a multipurpose flushing device was done and at the same time continuous intracranial pressure (ICP) monitoring was done on- and off-state of shunt system. When the shunt was closed, B wave (systoric pressure: 40 mmHg) appeared frequently. When the shunt was opened, B wave disappeared and resting pressure and pulse pressure decreased. The signs and symptoms of this patient improved after placement of the V-P shunt. These results supported Gardner's hydrodynamic theory of hydromyelia (syringomyelia).