Surgical Management of Spinal Arachnoid Cysts in Adults

Eroğlu, Ümit; Bozkurt, Melih; Kahiloğulları, Gökmen; Doğan, İhsan; Özgüral, Onur; Shah, Kushal; Zaimoğlu, Murat; Al‐Beyati, Eyyub S. M.; Ugur, Hasan Çağlar; Cohen-Gadol, Aaron

doi:10.1016/j.wneu.2018.11.005

Cited by 27 publications

(32 citation statements)

References 30 publications

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“…An increase in the intraspinal pressure could stimulate the movement of CSF into the cyst. 3 8) This ball valve mechanism might have been observed intraoperatively. Bony erosion of the spinal canal may suggest the presence of a valve like mechanism that is responsible for producing forces of CSF pressure within the cyst which are greater than normal hydrostatic forces.…”

Section: Discussionmentioning

confidence: 85%

“…It is inferred to be the most common in thoracic spine because of the narrow diameter and longest segment. 3) These anatomic features possibly lead to rapid detection discovery of symptoms caused by the mass effect on the spinal cord. 1) Although they are most commonly found in the thoracic spine, these cysts have also been reported to occur in the lumbar spine.…”

Section: Discussionmentioning

confidence: 99%

“…First, osmotic gradient and fluid production by the cells forming its wall(non-communicating) and one-way valve like mechanism between the cyst and subarachonoid space. 3 8 12) …”

Section: Discussionmentioning

confidence: 99%

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Extradural Spinal Arachnoid Cyst as a Cause of Cauda Equina Syndrome in a Child

Yoo

Kim

et al. 2020

Korean J Neurotrauma

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Although spinal arachnoid cysts are relatively common findings observed incidentally in adults, they are much rarely reported in children. They are usually asymptomatic and are mainly located in the middle and lower thoracic regions. However, in rare circumstances, these cysts can cause mass effects that lead to neurologic symptoms. We report the rare case of a spinal extradural arachnoid cyst in a 12-year-old boy who showed signs and symptoms of cauda equina syndrome. Magnetic resonance imaging of the lumbar spine revealed a huge extradural arachnoid cyst extending from L2 to L5. Emergent laminectomy and repair of dural defect was performed after total resection of the extradural arachnoid cyst. There were no postoperative complications. Total recovery was achieved 6 months after surgery. Here, we report this rare case with a review of the literature.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Extradural Spinal Arachnoid Cyst as a Cause of Cauda Equina Syndrome in a Child

Yoo

Kim

et al. 2020

Korean J Neurotrauma

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“…Third, the inflow of CSF onto the AC via the ball-valve action. Fourth, the increase of intraspinal CSF pressure could stimulate the movement of CSF into the cyst 134)…”

Section: Discussionmentioning

confidence: 99%

Cervical Cerebrospinal Fluid Leakage Concomitant with a Thoracic Spinal Intradural Arachnoid Cyst

Han

Choi

Park

et al. 2019

Korean J Neurotrauma

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We encountered a very rare case of spontaneous spinal cerebrospinal fluid (CSF) leakage and a spinal intradural arachnoid cyst (AC) that were diagnosed at different sites in the same patient. These two lesions were thought to have interfered with the disease onset and deterioration. A 30-year-old man presented with sudden neck pain and orthostatic headache. Diplopia, ophthalmic pain, and headache deteriorated. CSF leakage was confirmed in C2 by radioisotope cisternography, and an epidural blood patch was performed. While his symptoms improved gradually, paraparesis suddenly progressed. Thoracolumbar magnetic resonance imaging (MRI) revealed an upper thoracic spinal intradural AC, which was compressing the spinal cord. We removed the outer membrane of the AC and performed fenestration of the inner membrane after T3-4 laminectomy. Postoperative MRI showed complete removal of the AC and normalized lumbar subarachnoid space. All neurological deficits including motor weakness, sensory impairment, and voiding function improved to normal. We present a case of spontaneous spinal CSF leakage and consecutive intracranial hypotension in a patient with a spinal AC. Our report suggests that if spinal CSF leakage and a spinal AC are diagnosed in one patient, even if they are located at different sites, they may affect disease progression and aggravation.

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“…Spinal arachnoid cysts are discrete pockets of CSF or CSF-like fluid found adjacent to normal CSF spaces and related to the spine. They are rare pathological entities and represent only 1-3% of spinal canal lesions [1]. They are classified according to anatomical location into intradural and extradural cysts [2], and few cases of intramedullary arachnoid cysts have also been reported [3,4].…”

Section: Introductionmentioning

confidence: 99%

Surgical outcome of primary intradural spinal arachnoid cysts: a series of 10 cases

Abdelhameed

Morsy

2021

Egypt J Neurol Psychiatry Neurosurg

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Background Primary intradural spinal arachnoid cysts are rare pathologies of uncertain etiology and variable presentation from no symptoms to myelopathy or radiculopathy according to cord or root compression. MRI with diffusion and contrast differentiates them from many pathologies. There is a lot of debate regarding when to treat and how to treat such rare pathologies. Objective We present a series of 10 primary intradural arachnoid cysts and evaluate outcome after surgery. Methods This retrospective study includes patients having primary intradural spinal arachnoid cysts operated in two tertiary care centers from October 2012 till October 2019. Symptomatic cysts were subjected to microsurgical resection or outer wall excision and inner wall marsupialization under neurophysiological monitoring. The Japanese Orthopedic Association Score was used for clinical evaluation while MRI with contrast and diffusion was used for radiological evaluation before and after surgery. Results This series included 10 patients, 4 males and 6 females, with mean age of 40 years. Pain was the most common presentation. The most common location was dorsal thoracic region. Total excision was achieved in 2 cases and marsupialization in 8 cases. All symptoms improved either completely or partially after surgery. No neurological deterioration or recurrence was reported during the follow-up period in this series. Conclusion Treatment of symptomatic primary intradural spinal arachnoid cysts should be microsurgical resection, when the cyst is adherent to the cord, microscopic fenestration can be safe and effective.

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Surgical Management of Spinal Arachnoid Cysts in Adults

Cited by 27 publications

References 30 publications

Extradural Spinal Arachnoid Cyst as a Cause of Cauda Equina Syndrome in a Child

Extradural Spinal Arachnoid Cyst as a Cause of Cauda Equina Syndrome in a Child

Cervical Cerebrospinal Fluid Leakage Concomitant with a Thoracic Spinal Intradural Arachnoid Cyst

Surgical outcome of primary intradural spinal arachnoid cysts: a series of 10 cases

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