Spinal Cord Compression Caused by Extradural Arachnoid Cysts

Abstract

Most spinal arachnoid cysts are asymptomatic and detected incidentally during magnetic resonance imaging or myelography. The etiology of intraspinal arachnoid cyst is not yet clear. We present two children with three spinal extradural arachnoid cysts and each cyst protruded from a separate dura defect. In both patients, plain radiographs demonstrated widening of the interpedicular distance, which suggested progressive widening of the spinal bony canal. Limited laminectomy was performed to remove the intraspinal cysts. Separate dura defects, the apparent predisposing factors, were also found and repaired. The patients completely recovered neurologically. Radical cyst removal and dura defect closure are the surgical intervention of choice in patients with symptomatic extradural arachnoid cyst.

Spinal extradural arachnoid cysts

“…[12][13][14][15][16][17][18][19][20]22,[25][26][27][28][29] Excision of the cyst with closure of the defect is the mainstay of treatment in symptomatic patients. 2,5,6,8,10,11,30 The current report illustrates the largest series in the literature including four symptomatic extradural arachnoid cysts in whom en-block excision of the cyst and obliteration of the dural defect result in excellent recovery. The crucial role of MRI and its characteristic features in accurate preoperative diagnosis will be emphasized.…”

“…26-29 39,40 In symptomatic patients, the clinical picture is generally related to the gradual compression of the spinal cord or cauda equina and the corresponding nerve root affection. [2][3][4][6][7][8]12,13,[17][18][19]24 Duration of the symptoms might vary from one month to a quarter of century. 3,9,13,14,17,18,41 In children, the period prior the correct diagnosis and from diagnosis to surgery is short and is mostly from six to twelve months.…”

“…In the literature these cysts mostly appear as a single case reports or small series of two or three cases which indicate the rarity of these cysts. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Spinal arachnoid cysts located extradurally are most often encountered at mid--thoracic or thoracolumbar region. Although, they are also known to occur in the lumbosacral, cervicothoracic and cervical spine in decreasing frequency.…”

“…7,11,20,24 Spinal EACs seems to be more frequent in male patients than female subjects and more common in children and adolescents rather than adults, with peak incidence in the second decade of life. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] In pre MRI era, reports on extradural arachnoid cysts were extremely rare. However, with widespread application of MRI, such cysts are diagnosed earlier and reported increasingly.…”

Extradural Giant Multiloculated Arachnoid Cyst Causing Spinal Cord Compression in a Child

“…The related dural defect seems to be essential to the genesis of an extradural arachnoid cyst. In most of the cases, nontraumatic spinal extradural arachnoid cysts are considered to arise from a congenital dural defect, which allows the arachnoid membrane to herniate through the adjacent dura mater (2)(3)(4).…”