Subarachnoid and Intramedullary Cysts Secondary to Epidural Anesthesia for Gynecological Surgery

Abstract

Three women who received epidural anesthesia for gynecological surgery developed spinal arachnoiditis leading to subarachnoid cysts and cord cavitation. MRI was useful to show the subarachnoid and intramedullary cysts, as well as to monitor lesion extent and progress. Associated MRI findings were a Chiari anomaly in 1 case and a tethered cord in another. Two cases underwent surgery: 1 improved, but the other suffered progressive neurological deterioration. Although the 3rd patient had no treatment, there was spontaneous reduction in cavity size and clinical improvement. Careful handling of this procedure is urged to avoid such severe complications in young mothers.

Intramedullary Arachnoid Cyst of the Cervical Spine: Case Report and Literature Review

“…3 Acquired SACs are believed to be a result of the arachnoiditis following lumbar puncture, infection, epidural anesthesia, or procedures of spinal surgery. 4 The majority of the 21 reported cases of SIACs were located in the thoracic region (14 cases), and only 6 cases were in the cervical spine. Due to their rarity, their natural history is not well determined.…”

L’arachnoïdite médullaire adhésive : une complication tardive de l’analgésie péridurale obstétricale

“…Nous n'avons retrouvé dans la littérature que douze cas d'arachnoïdite après une analgésie péridurale obstétricale, avec des délais entre l'analgésie locorégionale et le diagnostic qui varient de deux mois à deux ans [2][3][4][5].…”