Quiste aracnoideo extradural espinal: reporte de un caso y revisión de la literatura

Abstract

There is currently no standard minimally invasive approach to surgically treat these cysts, but if the patient has mild symptoms, clinical observation is recommended.

Communicating spinal epidural thoracic arachnoid cyst en-bloc resection

“…Arachnoid cysts are benign developmental cysts that occur in the craniospinal axis in relation to the arachnoid membrane. We report a case of extra dural arachnoid cyst, for many authors the spinal arachnoid cysts may be intradural or extradural and are composed of normal or slightly thickened arachnoid (6) A spinal extradural arachnoid cyst is a rare disease, accounting for approximately 1% to 3% of spinal tumors (5,8). They can be idiopathic or acquired, usually intradural, but can also rarely be extradural, primary spinal arachnoid cysts present in the thoracic spine in 80%, Secondary arachnoid cysts are usually due to trauma, hemorrhage, inflammation, surgery, or lumbar puncture (8).…”

“…Various hypotheses have been proposed to explain why spinal arachnoid cysts form: 1proliferation or loculation of arachnoid trabeculae in the septum posticum; 2-a fault in the expansion of the arachnoid trabecula and 3-the formation of arachnoid diverticuli in weak areas of the spinal dura mater (5).…”

“…The differential diagnoses include: tarlov or perineural cyst,ganglion cyst, synovial cyst,epidermoid cysts, cystic neoplasms, parasitic cysts meningeal diverticula next to the nerve roots, meningocele, dermoid cyst,cysticercosis and hydatid cysts (1,5).…”

“…The management of these cysts can vary according to the patient's symptoms.There are many surgical options reported in the literature: bone decompression, subtotal or total resection of the cyst, drainage and marsupialisation of the cyst. In asymptomatic patients, conservative management with subsequentclinical observation is recommended (4,5).The goal of surgical treatment is not only neural decompression but also the prevention of cyst refilling.For symptomatic extradural spinal arachnoid cysts the preferred treatment is surgical removal of the cyst together with ligation of the communicating pedicle and closure of the dual defect (3,4). In the reported case we achieved the identification of the communication between the cyst and the subarachnoid spaces through a dural defect and after total excision en bloc we close the dural defect with a muscular patch.…”