Lumbar and Sacral Cysts of Meningeal Origin

Strully, Kenneth J.; Heiser, Saul

doi:10.1148/62.4.544

Cited by 68 publications

(21 citation statements)

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“…The author argues that an increase in CSF pressure forces the CSF into the normally obliterated perineural space to explain symptomatic fluctuations observed during the preoperative and postoperative course in patients with TC. 3,6,9,13,14) The perineurial cysts are meningeal dilations of the posterior spinal nerve root sheath that most often affect sacral roots and can cause a progressive painful radiculopathy or a symptomatology of medial compression as in our case. The TC are most commonly diagnosed by lumbosacral MRI and can often be demonstrated by computerized tomography (CT) myelography to demonstrate communication with the spinal subarachnoid space.…”

Section: Discussionmentioning

confidence: 75%

A rare cause of thoracic spinal cord compression by multiple large Tarlov cysts

et al. 2018

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IntroductionThe spinal extradural arachnoid cyst (SEAC) is a rare cause of spinal cord compression. The etiology of SEAC remains unclear. They appear to be extradural outpouchings of arachnoid membranes that communicate with the intraspinal subarachnoid space through small defect in the dura. 7,10,17) Tarlov cyst (TC) are predominantly found at the lumbosacral level of the spine but they are known to exist at all levels of the spine. Bifocal location of SEACs, thoracic and sacral, is exceedingly rarely reported in the literature. Here in we report a case of thoracic spinal cord compression by SEAC associated with asymptomatic multiple sacral cysts. The surgical management and postoperative outcome are discussed. Case ReportA 34-year-old woman with no history of trauma was referred to the emergency department for acute thoracic pain superimposed on a background of chronic long-standing back pain. The patient was complaining of walking difficulties. Neurological examination demonstrated an incomplete spastic paraplegia, grade 2 motor power in both lower limbs, with sensory level in T9, with pyramidal syndrome in the inferior limbs bilateral plantar extension responses, with hyperreflexia of both Achilles tendons reflexes were present. Sensory, bladder, and bowel functions were unremarkable. Imaging a spinal magnetic resonance imaging Spinal extradural arachnoid cyst (SEAC) is a rare cause of spinal cord compression. Bifocal location of thoracic and sacral SEACs is rarely reported in the literature. We report a case of thoracic spinal cord compression by SEAC associated with asymptomatic multiple sacral Tarlov cysts (TC). The surgical management and postoperative outcome of the patient are discussed. A 34-year-old woman was referred to the hospital for acute thoracic pain with a history of chronic long-standing back pain. She complained of walking difficulties. Neurological examination demonstrated incomplete spastic paraplegia with sensory level in T9. Magnetic resonance imaging revealed a large cystic formation from T7 11 and at the level of the sacrum. We performed laminectomies at the level of interest from T7 11. The cysts were dissected from the underlying dura after removal of the cerebrospinal fluid. We found nerve tissue in the cysts. We excised the cyst and preserved the nerve roots. Subsequently, a duraplasty was performed with autologous grafts from the lumbar fascia. The condition of the patient improved after surgery and he was recovering well at follow-up. Although the surgical treatment of TC is controversial, especially at the sacral lumbar level, decompression at the dorsal level in this case is indisputable. KEY WORDS Extradural arachnoid cyst ㆍSpinal cord compression ㆍTarlov cyst.

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Section: Discussionmentioning

confidence: 75%

A rare cause of thoracic spinal cord compression by multiple large Tarlov cysts

et al. 2018

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“…The proposed etiologies for the perineural cysts include ischaemic degeneration, inflammation, hemorrhage, trauma, arachnoid proliferation, obstruction of perineural lymphatic flow or developmental origin [1,3,[8][9][10][11]. Several authors have proposed that increased CSF hydrostatic pressure may be a factor in the origin of perineural cysts or their growth and becoming symptomatic [4,12,13]. The patient in this study had a history of heavy lifting at work-maneuver that raises CSF pressure.…”

Section: Introductionmentioning

confidence: 84%

“…Surgical treatment options include deompressive laminectomy, cyst wall resection, cyst fenestration and imbrication and cyst shrinkage using bipolar cautery [9,12,[17][18][19]. However complications like postoperative pseudomeningocele and neurological deficits occur.…”

Section: Introductionmentioning

confidence: 99%

Complete Manuscript Title: Symptomatic Bilateral Cervical Perineural Cyst

Dharmadhikari¹

2016

MOJOR

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“…Surgical treatments include cyst resection at the neck, cyst wall resection or fulguration, cyst fenestration and imbrication, and complete cyst removal with excision of the affected nerve root. 2,6,[22][23][24][25] However, the main drawback of this surgical management is the high risk of recurrence and complications (such as meningitis, nerve damage, and CSF leak). More recently, a nonsurgical method with CT-guided percutaneous cyst drainage has been introduced as an alterative therapy for symptomatic sacral arachnoid cysts.…”

Section: Discussionmentioning

confidence: 99%

CT-Guided Percutaneous Injection of Fibrin Glue for the Therapy of Symptomatic Arachnoid Cysts

Shao¹,

Wang²,

Wu³

et al. 2011

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Although often asymptomatic, enlarging sacral arachnoid cysts can also cause significant discomfort. These symptomatic sacral arachnoid cysts require specific treatments to facilitate local decompression. The main drawback of the surgical managements is the high risk of recurrence and complications. To decrease risks, we had been attempting to seek a simple and safe method to manage the symptomatic sacral arachnoid cysts. CT-guided percutaneous fibrin glue therapy is a new nonsurgical alternative. To evaluate the efficacy of the novel nonsurgical approach, we conducted this retrospective study of 38 patients.

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Lumbar and Sacral Cysts of Meningeal Origin

Cited by 68 publications

References 0 publications

A rare cause of thoracic spinal cord compression by multiple large Tarlov cysts

A rare cause of thoracic spinal cord compression by multiple large Tarlov cysts

Complete Manuscript Title: Symptomatic Bilateral Cervical Perineural Cyst

CT-Guided Percutaneous Injection of Fibrin Glue for the Therapy of Symptomatic Arachnoid Cysts

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