A rare anterior spinal epidural cyst mimicking Hirayama disease

Rahmlow, Megan R.; Pirris, Stephen M.; Rubin, Devon I.

doi:10.1002/mus.22316

Cited by 7 publications

(6 citation statements)

References 15 publications

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“…Cases of SADD revealed by BA are less frequent than those associated with intracranial hypotension or SS, with only 18 patients reported in the literature. 8,9,[11][12][13][14][15][16][17][18] However, our hypothesis is that BA is yet another clinical presentation of the same entity, as evidenced by several reports combining a motor deficit of the upper limbs and either SIH 11,14,16 or SS. 9,15 Therefore, we propose a unifying approach in which a single etiology (SADD) can be revealed by multiple clinical presentations: BA (SADD-BA), SIH (SADD-SIH), or SS (SADD-SS) (Table 3).…”

Section: Discussionmentioning

confidence: 85%

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Spinal Anterior Dural Dissection: Moving From Differential to Unifying Diagnosis

Knafo,

Herbrecht,

Cauquil

et al. 2024

Neurosurgery

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BACKGROUND AND OBJECTIVES: Cerebrospinal fluid (CSF) collections extending longitudinally at the anterior aspect of the spinal dura have been reported in association with various conditions and under multiple names. The aim of this study was to report cases associated with brachial amyotrophy (BA) and examine its relationship with other clinical variants. METHODS: We conducted a retrospective cohort study including patients who presented with a motor deficit of the upper limbs and an anterior interdural CSF collection on spinal MRI. We performed a systematic review of the literature to include cases revealed by BA. RESULTS: Seven patients presenting with BA and a confirmed dural dissection on spinal MRI were included. All patients were male with a slowly progressing history of asymmetrical and proximal motor deficit of the upper limbs. Chronic denervation affecting mostly C5 and C6 roots was found on electroneuromyography. Spinal MRI demonstrated an anterior CSF collection dissecting the interdural space and exerting a traction on cervical motor roots. Dynamic computed tomography myelogram localized the dural defect every time it was performed (4/7 cases), and surgical closure was possible for 3 patients, leading to resolution of the collection. Literature review yielded 18 other published cases of spinal dural dissections revealed by BA, including 4 in association with spontaneous intracranial hypotension and 4 others in association with superficial siderosis. CONCLUSION: We propose a unifying diagnosis termed “spinal anterior dural dissection” (SADD) to encompass spinal dural CSF collections revealed by BA (SADD-BA), spontaneous intracranial hypotension (SADD-SIH), or superficial siderosis (SADD-SS).

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Section: Discussionmentioning

confidence: 85%

“…We found 18 cases of SADD revealed by BA published in the literature, mostly case reports and small case series 8,9,[11][12][13][14][15][16][17][18] (Table 2). Notably, all patients were men, aged between 26 and 68 years, presenting with a slowly progressing bibrachial motor deficit of the upper limbs.…”

Section: Systematic Reviewmentioning

confidence: 99%

Spinal Anterior Dural Dissection: Moving From Differential to Unifying Diagnosis

Knafo,

Herbrecht,

Cauquil

et al. 2024

Neurosurgery

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“…4 Anterior extradural spinal cysts mimicking HD or ALS has been described previously. [5][6] Rahmlow et al described a 34year old man with a 5-year history of progressive forearm weakness and atrophy. MRI showed a longitudinally extensive anterior spinal extradural cyst extending from C2 to L1.…”

Section: Discussionmentioning

confidence: 99%

“…Patient's strength improved after receiving surgical cyst drainage and fenestration. 5 Schmalbach et al described 3 male patients who presented to ALS clinic with weakness and fasciculations in the upper extremities. Clinical and electrophysiological studies in these patients was in accordance with a diagnosis of possible ALS by the revised El Escorial criteria.…”

Section: Discussionmentioning

confidence: 99%

“…6 Like our patient, all 5 patients presented with an asymmetrical upper extremity weakness and atrophy with a symptomatic duration of 5 years or longer. [5][6] The etiology of cyst formation in our patient could be related to a minor trauma. Anterior spinal cysts may cause motor neuron dysfunction by compressing anterior spinal arteries leading to compromised microcirculation and eventual anterior horn cell death or compressing ventral roots.…”

Section: Discussionmentioning

confidence: 99%

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Anterior Spinal Extradural Cyst Mimicking Hirayama Disease and Amyotrophic Lateral Sclerosis

Pike-Lee

Twydell

2020

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Monomelic amyotrophy in cervical myelopathy associated with anterior dural sac displacement induced by neck flexion

et al. 2016

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A rare anterior spinal epidural cyst mimicking Hirayama disease

Abstract: Anterior cervical epidural spinal cysts should be considered in the differential diagnosis in patients who present with slowly progressive hand weakness.

Cited by 7 publications

References 15 publications

Spinal Anterior Dural Dissection: Moving From Differential to Unifying Diagnosis

Spinal Anterior Dural Dissection: Moving From Differential to Unifying Diagnosis

Anterior Spinal Extradural Cyst Mimicking Hirayama Disease and Amyotrophic Lateral Sclerosis

Monomelic amyotrophy in cervical myelopathy associated with anterior dural sac displacement induced by neck flexion

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