Spinal intramedullary neuroepithelial (ependymal) cyst. A rare cause of treatable acute para paresis

Abstract

An 8-yr-old female child presented with acute onset of severe pain in the lower limbs and difficulty in walking. Spine MRI showed hyperintense signals on T2 weighted images at T2-T3 level, which was intramedullary in location. The patient was operated and histopathology reported as neuroepithelial cyst. Spinal intramedullary neuroepithelial cysts are rare. Spinal cord compression due to the cyst is very uncommon and because of its rarity the present case is being reported. The clinical features, embryogenesis and literature were reviewed briefly.

Mobile Myxopapillary Ependymoma with Associated Filum Terminale Cyst

“…Ependymal cysts can be found throughout the neuraxis, [1][2][3][4][5][6] but there is only one report of an ependymal cyst below the conus medullaris. 7 In Table 1, [1][2][3][4][5][6][7][13][14][15][16][17][18][19][20][21][22] we summarize the reports of spinal ependymal cysts. These lesions are developmental in origin and lined with ependymal cells.…”

Intra-Extramedullary Drainage as an Effective Option for Treatment of Intramedullary Ependymal Cyst of Thoracic Spine: Technical Note

“…is slowly progressive, making the differential diagnosis with other spinal lesions sometimes difficult; however, a rapid clinical onset has also been reported in the literature. 11 MRI with gadolinium-diethylene triamine penta-acetic acid (Gd-DTPA) is the study of choice to detect neuroepithelial cysts: these lesions generally appear hypointense on T1-weighted images, hyperintense on T2-weighted images, and nonenhanced on Gd-enhanced T1-weighted images. 18,19 The fact that the cyst wall does not enhance helps to differentiate ependymal cysts from other spinal lesions.…”

“…In our experience in treating intra-extramedullary lesions, either oncological or not, we had excellent results using MEPs and SEPs. 10,11,14 We believe that the use of neurophysiological monitoring makes the procedure safer, especially in relation to the manipulation of the spinal cord during the introduction of the tube, and makes total removal of the cyst wall and the placement of the Nelaton tube inside the shunt more feasible.…”