Multiple spinal extradural arachnoidal cysts: An uncommon cause of thoracic cord compression

Nayak, Raghavendra; Chaudhuri, Anupkumar; Sadique, Shahid I.; Attry, Sanjeev

doi:10.4103/1793-5482.150004

Cited by 10 publications

(3 citation statements)

References 9 publications

(21 reference statements)

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“…A congenital etiology has been put forward for these cysts, involving either congenital diverticula of the dura or arachnoid herniation through a congenital dural defect. 10) Nabors et al 8) classified these SEACs into three types:…”

Section: Discussionmentioning

confidence: 99%

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: 99%

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

et al. 2018

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“…A congenital etiology has been put forward for these cysts, involving either congenital diverticula of the dura or arachnoid herniation through a congenital dural defect. 10) …”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

A Rare Cause of Thoracic Spinal Cord Compression by Multiple Large Tarlov Cysts

Kleib

Salihy

Hamdi

et al. 2018

Korean J Neurotrauma

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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.

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