Communicating syringomyelia associated with ventriculoperitoneal shunt malfunction verified with a cerebrospinal fluid dynamic study: case report.

HISTORY: A 20-year-old male presented with neck pain and motor impairment of the upper extremities because of recurrent syringomyelia caused by ventriculoperitoneal shunt malfunction. EXAMINATION AND OPERATION: A computed tomography scan after shuntgraphy demonstrated opacity in the intracranial ventricular system and cervical syrinx with contrast medium, which indicated communication between the fourth ventricle and syrinx. His symptoms resolved immediately after peritoneal catheter replacement, and magnetic resonance images obtained 1 week after surgery showed the complete resolution of hydrocephalus and syringomyelia.
CONCLUSION: Syringomyelia associated with ventriculoparitoneal shunt malfunction is a well-known complication in myelodysplastic patients; however, this is the first case in which communicating syringomyelia was verified with a cerebrospinal fluid dynamic study. As the present case involved communicating syringomyelia, it could only be resolved by shunt revision surgery.