Utility of Preoperative Magnetic Resonance Imaging Myelography for Identifying Dural Defects in Patients with Spinal Extradural Arachnoid Cysts: Case Report

Miyamoto, Michiyuki; Kim, Kyongsong; Matsumoto, Ryoji; Isobe, Masanori; Isu, Toyohiko

doi:10.1227/01.neu.0000232659.56174.28

Cited by 33 publications

(27 citation statements)

References 10 publications

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“…24 MRI myelography scans may be more effective than MRI cine scans in demonstrating the cysts. 25 The failure of MRI scanning to demonstrate Tarlov cysts in the two patients from our case series may therefore represent a technical imaging problem rather than the true absence of a cyst. The effect of pregnancy on Tarlov cysts is unknown.…”

Section: Anatomical Abnormalitiesmentioning

confidence: 80%

Complete failure of spinal anaesthesia in obstetrics

Hoppe¹,

Popham²

2007

International Journal of Obstetric Anesthesia

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Section: Anatomical Abnormalitiesmentioning

confidence: 80%

Complete failure of spinal anaesthesia in obstetrics

Hoppe¹,

Popham²

2007

International Journal of Obstetric Anesthesia

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“…SEACs are assumed to be the result of dural defects. Communication between the cysts and the intradural subarachnoid space has been reported in nearly all cases of arachnoid cysts 6,8) . The cause of dural defect can be congenital or acquired.…”

Section: Pathogenesis and Classificationmentioning

confidence: 99%

Spinal extradural arachnoid cyst

Choi¹,

Kim

Lee³

et al. 2006

Acta Neurochir (Wien)

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A 59-year-old man presented with both leg radiating pain and paresthesia for 4 years. Other physical findings were not remarkable. MRI showed a large, elongated posterior extradural cyst from T12 to L3 with surrounding bony erosion (Fig. 1A, B).Thinned overlying laminas were found on operative field and the cyst was ruptured during laminectomy. There was a hole-like dural defect near to right L1 root sleeve and we performed primary closure of the defect. Some part of cyst wall was also removed.The patient's symptoms were gradually subsided and follow up image taken 1 month after the operation showed complete disappearance of the cyst (Fig. 1C). Case 2A 51-year-old female patient visited our clinic with left buttock pain and paresthesia for 3 years. Her pain was aggravated on coughing and she also complained of gait disturbance with both sole numbness on walking.MRI showed a large extradural cyst located posterior to the INTRODUCTIONSpinal extradural arachnoid cyst (SEAC) is a rare disease and uncommon cause of compressive myelopathy. SEAC is more commonly found among male patients and during the second decade of their life. SEACs can be found in any location, although mostly reported to be located at mid thoracic to the thoraco-lumbar junction, commonly in a posterior position 1,3,4,6,10,12) . SEAC is an outpouching herniation of arachnoid membrane through a dural defect that may communicate to intradural subarachnoid space 5) . The etiology of this herniation is still unclear and can be either congenital or acquired 6) . These cysts can result in fluctuating symptoms associated with cord or root compression. It is assumed that they can be enlarged by subsequent pressure change in the cerebrospinal fluid (CSF) during exercise and Valsalva maneuvers as there is micro-communication between the cysts and subarachnoid space 2,6) . Despite the rarity of SEACs, they are important in neurosurgical view because they are surgically curable disease. Diverse surgical techniques have been introduced and many reports reviewed favorable outcome of SEACs with surgical treatment. We experienced 2 cases of SEACs and performed cyst fenestration and primary repair of dural defects for all of them. The aim of this article Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaSpinal extradural arachnoid cyst (SEAC) is a rare disease and uncommon cause of compressive myelopathy. The etiology remains still unclear. We experienced 2 cases of SEACs and reviewed the cases and previous literatures. A 59-year-old man complained of both leg radiating pain and paresthesia for 4 years. His MRI showed an extradural cyst from T12 to L3 and we performed cyst fenestration and repaired the dural defect with tailored laminectomy. Another 51-year-old female patient visited our clinical with left buttock pain and paresthesia for 3 years. A large extradural cyst was found at T1-L2 level on MRI and a communication between the cyst and subarachnoid space was illustrated by CT-myelography. We performed cys...

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“…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.…”

Section: Discussionmentioning

confidence: 86%

Dural Repair for Intraspinal Extradural Meningeal Cyst -Case Report-

Tei

Morimoto

Miyamoto

et al. 2007

Neurol. Med. Chir.(Tokyo)

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A 52-year-old woman presented with an intraspinal extradural meningeal cyst in the thoracolumbar region manifesting as progressive sensory disturbance of the bilateral lower extremities. Magnetic resonance imaging and computed tomography myelography showed an extradural meningeal cyst extending from the T-12 to L-4 levels in the thoracolumbar region with a dural defect and a valve-like mechanism developed in the enlarging cyst. Operative findings revealed a dural defect that allowed communication between the extradural cyst cavity and the subarachnoid space. Surgical resection of the cyst wall and repair of the dural defect resolved the symptoms.

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Utility of Preoperative Magnetic Resonance Imaging Myelography for Identifying Dural Defects in Patients with Spinal Extradural Arachnoid Cysts: Case Report

Abstract: Because the preoperative MRI myelography scan correctly identified the existence and location of the dural defect, we conclude that MRI myelography is helpful for detecting dural defects in patients with epidural arachnoid cysts.

Cited by 33 publications

References 10 publications

Complete failure of spinal anaesthesia in obstetrics

Complete failure of spinal anaesthesia in obstetrics

Spinal extradural arachnoid cyst

Dural Repair for Intraspinal Extradural Meningeal Cyst -Case Report-

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