Spinal extradural meningeal cyst

Abstract

The case of a 30-year-old man with a spinal extradural meningeal cyst in the thoracolumbar region is reported. Operative findings revealed a dural defect that allowed communication between the extradural cyst cavity and the subarachnoid space. Application of the Valsalva maneuver made the cerebrospinal fluid flow into the cyst cavity; however, reverse flow did not occur. These findings indicate that a valvelike mechanism developed in the enlarging cyst. Surgical resection of the cyst wall and closure of the dural defect provided a favorable result.

Dural Repair for Intraspinal Extradural Meningeal Cyst -Case Report-

“…This valve-like mechanism would make the intracystic CSF pressure greater than the normal hydrostatic pressure. 20) MR imaging showed the dural defect as a flow void in the present case. Cinematic MR imaging 14) and MR imaging myelography 12) were also helpful for detecting dural defects with epidural arachnoid cyst in the previous reports.…”

“…1,3-8, 11,13,15,[17][18][19][20] Cystoperitoneal shunt therapy, 1) simple cyst puncture, 15) or epidural blood patch 3) have been undertaken in some cases, but complete resection of the cyst followed by tight closure of the cyst and the fistula is generally thought to be the gold standard of surgical treatment. If complete resection is difficult because the cyst is tightly adherent to the neural tissue or the dura, or because of intraoperative bleeding from a well-developed epidural venous plexus, partial resection of the cyst, and closure of the fistula have been recommended.…”

“…Cyst expansion may result from active secretion from the internal cell lining, osmotic spinal gradient between the subarachnoid space and cyst, pulsatile cerebrospinal fluid (CSF) dynamics, and valve-like mechanisms. 5,13,20) Surgical treatment is required if neurological symptoms develop due to cyst-induced spinal cord or nerve root compression.…”

Spinal Extradural Meningeal Cyst in Klippel-Trenaunay Syndrome

“…The development of Type I SEMC may be attributed to the congenital diverticulum of the dura or arachnoidal herniation due to a congenital dural defect. This is supported by hereditary syndrome 4,7,26) , familial tendency 4) , or associated congenital anomalies 11,22) . The hereditary syndrome of multiple congenital extradural cysts is associated with distichiasis and lymphedema 14) .…”

Spinal Extradural Arachnoid Cyst. Case Report.

“…[2][3][4][5][6][7][8][9] The patients were eight males and two females, aged from 11 to 49 years. Four patients were teenagers and four were in the forties.…”