Spinal arachnoid cyst with weakness in the limbs and abdominal pain

Aithala, Guru Raj; Sztriha, László; Amirlak, Iradj; Devadas, K.; Ohlsson, Ingrid

doi:10.1016/s0887-8994(98)00131-3

Cited by 30 publications

(39 citation statements)

References 6 publications

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“…Our patient's chronic intermittent history made the diagnosis elusive. Patients with significant intraspinal lesions and no neurological symptoms can develop neurological symptoms rapidly (1,2,7,9,12). In our case, the mechanism for the radiating abdominal pain was most likely due to thoracic nerve root compression with resultant thoracic radiculopathy and spinothalamic tract injury.…”

Section: Discussionmentioning

confidence: 59%

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Thoracic meningioma masquerading as chronic abdominal pain

Lyons

Windgassen

Kinney

et al. 2010

Turkish Neurosurgery

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Chronic abdominal pain without a structural or metabolic gastroenterological etiology can be extremely challenging to diagnose. Patients presenting with an associated radicular pattern of pain may alert the clinician to a possible structural neurological cause of the symptoms. We present the case of a 70-year-old woman who presented to our institution with an 18-month history of right upper quadrant abdominal pain. She had no associated symptoms or provoking factors. She underwent an extensive gastroenterology evaluation, including colonoscopy that was unrevealing. Ultrasound demonstrated gallstones and she was evaluated for cholecystectomy. She subsequently developed right costal margin pain. Her symptoms remained stable over the course of the next year. Follow-up general surgical evaluation was still unconvincing that the gallstones were the etiology of her symptoms. A thoracic spinal MR demonstrated a large intradural extramedullary mass at T8. The patient's neurological exam was normal. She underwent a thoracic laminectomy and resection of meningioma with intraoperative electrophysiological monitoring. Her abdominal pain resolved. Patients can present with months to years of elusive abdominal symptoms only to be eventually found to be harboring an undiagnosed spinal tumor. We discuss the case and review the literature reports of spinal tumors masquerading as chronic abdominal pain. KeywoRds: Thoracic meningioma, Spinal cord, Abdominal pain ÖZYapısal veya metabolik bir gastroenterolojik etiyoloji olmadan kronik abdominal ağrının tanısını koymak çok zor olabilir. İlişkili radiküler ağrı paterniyle gelen hastalar klinisyenin bu yakınmaların olası bir yapısal nörolojik nedeni olabileceği konusunda dikkatli olmasını sağlayabilir. Hastanemize 18 aydır sağ üst kadranda abdominal ağrı öyküsüyle gelen 70 yaşında bir kadın sunulmuştur. Herhangi bir ilişkili belirti veya uyarıcı faktör bulunmamıştır. Kolonoskopi dahil yapılan kapsamlı gantroenteroloji değerlendirmesinde pozitif bir bulgu saptanmamıştır. Ultrason safra taşları göstermiş ve hasta kolesistektomi açısından değerlendirilmiştir. Daha sonra sağ kosta kenarında ağrı gelişmiştir. Belirtileri sonraki yıl boyunca stabil olarak devam etmiştir. Takiplerde yapılan genel cerrahi değerlendirmesi halen belirtilerin nedeninin safra taşları olduğu konusunda inandırıcı bulunmamıştır. Yapılan torasik spinal MR T8 seviyesinde büyük bir intradural ekstramedüller kitle göstermiştir. Hastanın nörolojik muayenesi normaldir. İntraoperatif elektrofizyolojik izlemeyle birlikte torasik laminektomi ve menenjiyom rezeksiyonu yapılmıştır. Abdominal ağrı kaybolmuştur. Hastalar aylar veya yıllar süren şüpheli abdominal belirtilerle başvurup daha sonra tanı konmamış bir spinal tümörleri olduğu saptanabilir. Vakayı sunuyor ve kronik abdominal ağrı görünümü veren spinal tümörlerin literatür raporlarını gözden geçiriyoruz.

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Section: Discussionmentioning

confidence: 59%

“…Abdominal pain associated with spinal pathology is more often reported in patients with neurological symptoms either at time of presentation or shortly thereafter (1,3,7,8,10,11,12,14). Spinal cord tumors associated with abdominal pain are rare, but occur in children and adults.…”

Section: Discussionmentioning

confidence: 99%

Thoracic meningioma masquerading as chronic abdominal pain

Lyons

Windgassen

Kinney

et al. 2010

Turkish Neurosurgery

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“…In a series of 99 children, held by Campagna et al between 1 years and 6 years of age that underwent decompressive surgery for spinal cord compression, only 1 case it was an arachnoid cyst [12]. Intramedullary arachnoid cysts are even rarer, and since its first description by Aithala et al in 1999 [13] Usually arachnoid cysts accompany others defects of maturation of the neural tube. In 1937, Voss first described the association between congenital cysts and dysraphic anomalies [4].…”

Section: Discussionmentioning

confidence: 99%

“…All cases of purely intramedullary arachnoid cysts reported in the literature showed a growth overtime accompanied by sudden neurological deterioration, requiring immediate surgical evacuation [3,4,[6][7][8][9][10][11][13][14][15][16][17][18]. To date, there is no existing literature on a quiescent intramedullary arachnoid cyst detected incidentally in an asymptomatic subject [10].…”

Section: Discussionmentioning

confidence: 99%

“…None of these showed worsening of the preoperative neurological deficits. Instead all the patients presented a clear improvement during the first weeks following the procedure, which was independent from the duration or severity of symptoms [3,4,[6][7][8][9][10][11][13][14][15][16][17][18]. The authors report the only published case of intramedullary adult arachnoid cyst with neurological stability during follow-up (five years), and managed with a wait and scan approach.…”

Section: Discussionmentioning

confidence: 99%

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An Adult Cervical Intramedullary Arachnoid Cyst: Case Report and Review

Fonseca¹,

Ratilal²

2017

J Spine

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Spinal arachnoid cysts are uncommon benign lesions that occur in the spinal axis, and can cause spinal cord or nerve roots compression and may become clinically relevant.The authors report a 49-year-old woman who presented progressive onset of cervical pain with distal paraesthesia of the upper limbs associated to an intramedullary arachnoid cyst in the mid-cervical spine diagnosed by MRI.From the literature review, only six cases in patients over 18-year-old were found, all with thoracic location and one with cervical extension, and all were submitted to decompressive surgery.The authors described the first intramedullary arachnoid cyst with a wait and scan approach.

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Anatomic Locations of Arachnoid Cysts

Akhaddar

2023

Arachnoid Cysts

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Spinal arachnoid cyst with weakness in the limbs and abdominal pain

Cited by 30 publications

References 6 publications

Thoracic meningioma masquerading as chronic abdominal pain

Thoracic meningioma masquerading as chronic abdominal pain

An Adult Cervical Intramedullary Arachnoid Cyst: Case Report and Review

Anatomic Locations of Arachnoid Cysts

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