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Suthar PP, Ozen M, Bhanot S, Dua SG. Imaging review of the atypical spinal epidural space pathologies. Curr Probl Diagn Radiol 2024; 53:507-516. [PMID: 38341368 DOI: 10.1067/j.cpradiol.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 01/28/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024]
Abstract
Pathologies affecting the spinal epidural space (SES) comprise various abnormalities. However, they all have the potential to cause thecal sac narrowing or spinal cord compression. In this review, we group these pathologies into degenerative, infective, neoplastic, vascular, traumatic, and others, focusing on their imaging features. Degenerative pathologies of the SES range from disc to facet disease, with a particular emphasis on the less common degenerative pathologies in this review. Infective pathologies affecting the epidural space include spondylodiscitis and associated epidural phlegmon and abscess. Neoplasms arising from typical SES components include neurofibroma, hemangioma, and liposarcoma. MRI is the best modality to assess the anatomy and abnormalities of the epidural space. MRI, combined with computed tomography, or a radiograph, is useful for the evaluation of bones or radiopaque foreign bodies.
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Affiliation(s)
- Pokhraj Prakashchandra Suthar
- Rush University Medical Center, Diagnostic Radiology and Nuclear Medicine, 1653 West Congress Parkway, Chicago, IL 60612, USA
| | - Merve Ozen
- Assistant Professor of Radiology, Surgery, Obstetrics and Gynecology, University of Kentuky College of Medicine, Faculty, Vascular & Interventional Radiology, 800 Ross Steet, Room HX-318, Lexington, KY 40536-0293, USA
| | - Shelly Bhanot
- Rush University Medical Center, Vascular & Interventional Radiology, 1653 West Congress Parkway, Chicago, IL 60612, USA
| | - Sumeet G Dua
- Rush University Medical Center, Diagnostic Radiology and Nuclear Medicine, 1653 West Congress Parkway, Chicago, IL 60612, USA.
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Messerer R, Aldugman M, Morgado A, Barrey C. Spinal extradural arachnoid cysts: a rare entity and review of the literature. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:872-880. [PMID: 38063861 DOI: 10.1007/s00586-023-08057-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 09/30/2023] [Accepted: 11/18/2023] [Indexed: 03/19/2024]
Abstract
OBJECTIVE Spinal extradural arachnoid cysts (SEDC) are rare primary spinal lesions, accounting for less than 1% of all spinal epidural lesions. The literature contains only case reports of this pathology, and treatment remains controversial due to its rarity. Major reported SEDC cases are caused by leaking out of cerebrospinal fluid through a dural defect in the thecal sac forming an extradural cyst. Other reports describe non-communicating SEDC cases where the dural defect was not identified. We report a literature review on SEDC and the case of a 53 year‑old female who presented with type IA extradural cyst with subarachnoid space communication. METHODS Literature review, preoperative imaging and surgical technique. RESULTS The extradural cyst was excised completely and the dural defect was repaired. After surgical decompression, neurological symptoms gradually recovered. CONCLUSIONS The extradural arachnoid cyst is an uncommon entity. Preoperative imaging is one of the determining elements in orienting the therapeutic management of the SEDCs. The choice of the surgical technique must be the least invasive in order to avoid postoperative complications. Subtotal or complete excision of the cyst, followed by obliteration of the communication stalk and repair of the dural defect is the gold standard treatment.
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Affiliation(s)
- Rostom Messerer
- Department of Neurosurgery, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.
- Department of Neurosurgery, Annecy Genevois Hospital, Epagny Metz-Tessy, France.
| | - Mohammed Aldugman
- Department of Neurosurgery, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - Alexis Morgado
- Department of Neurosurgery, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - Cédric Barrey
- Department of Neurosurgery, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
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Sunada Y, Yagi K, Tao Y, Nishimura H, Hishikawa T. Preoperative examination and intraoperative cerebrospinal fluid leakage test for minimally invasive surgery of spinal extradural arachnoid cysts: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2023; 6:CASE23319. [PMID: 37992305 PMCID: PMC10664627 DOI: 10.3171/case23319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 09/06/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Spinal extradural arachnoid cysts (SEACs) are rare and can cause spinal dysfunction. Total cyst removal and duraplasty via multiple laminectomies are commonly performed. However, to avoid postoperative spinal deformity and axial pain, a minimally invasive surgery via selective laminectomy may be optimal. Therefore, preoperative detection of the dural fistula site is required. OBSERVATIONS A 25-year-old male presented with a 2-month history of progressive gait disturbance and back pain. Conventional magnetic resonance imaging (MRI) revealed SEACs at the T9 to L2 level but did not reveal the dural fistula. Further examinations were performed using sagittal time-spatial labeling inversion pulse MRI and cone-beam computed tomography myelography with a spinal intrathecal catheter, which indicated a dural fistula on the left side at the T12 level. On the basis of these results, dural repair was performed via selective laminectomy. Furthermore, an intraoperative cerebrospinal fluid leakage test by intrathecally injecting saline via a spinal catheter confirmed complete closure of the dural fistula, with no other fistulas. LESSONS These comprehensive pre and intraoperative examinations may be useful for minimally invasive and selective surgeries in patients with SEACs.
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Epstein NE. Review/Perspective On the Diagnosis and Surgical Management of Spinal Arachnoid Cysts. Surg Neurol Int 2022; 13:98. [PMID: 35399888 PMCID: PMC8986646 DOI: 10.25259/sni_153_2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 11/04/2022] Open
Abstract
Background:
Spinal arachnoid cysts (SAC) are typically congenital, spontaneous, traumatic (i.e., including iatrogenic/surgical), or inflammatory in origin. In descending order, they occur in the thoracic, lumbar, and cervical spine, and originate from focal entrapment of the arachnoid membrane. Arachnoid cysts represent 1–2% of all cystic spinal masses/tumors. The majority are extradural arachnoid cysts (EDAC) while 10% of all arachnoid cysts are intradural (IDAC) including subarachnoid, or extra-arachnoidal/subdural. Only rarely are they intramedullary in location. The clinical symptoms/signs of IDAC/EDAC include; intracranial hypotension (i.e., due to continued cerebrospinal fluid drainage), radiculopathy, and/or myelopathy.
Methods:
Magnetic Resonance Images (MR) and Myelo-Computed Tomography (Myelo-CT) studies classically document the predominant dorsal location of IDAC/EDAC. They also show their extent and severity contributing to root, cord, and/or cauda equina compression. In the cervical/thoracic spine, MR/Myelo-CT studies classically show the “double cord” or “windsock” signs, while the “fake arachnoiditis sign” may be seen in the lumbar spine. The latter sign signals the presence of a circumferential extra-arachnoidal-subdural cyst that centrally “traps” the cauda equina. Note, that this resembles and is often misinterpreted as adhesive archnoiditis.
Results:
Patients with significant SAC-related neurological deficits typically warrant early surgery. That surgery includes; partial/total resection/fenestration of cyst walls, and occlusion of communicating fistulas with or without accompanying shunts.
Conclusion:
It is critical to recognize the clinical (i.e., intracranial hypotension, radiculopathy, and/or myelopathy) and radiographic MR/Myelo-CT signs (i.e., “double cord,” “windsock signs”, or “fake arachnoiditis sign”) of IDAC, EDAC, or intramedullary spinal arachnoid cysts to appropriately offer treatment. For those with significant neurological deficits, early surgery (i.e. optimally 0-< 24 hours after the onset of symptoms/signs consisting of laminectomies, partial/total cyst resection/fenestration, and ligation/occlusion of the subarachnoid-cyst fistula with or without shunt placement), is essential to avoid significant permanent neurological sequelae.
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Kita D, Yoshida Y, Enkaku F. Development of a Lumbar Extradural Arachnoid Cyst Associated with a Lumbar Catheter of Lumboperitoneal Shunt: A Case Report. NMC Case Rep J 2022; 8:811-816. [PMID: 35079553 PMCID: PMC8769440 DOI: 10.2176/nmccrj.cr.2021-0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 10/20/2021] [Indexed: 11/30/2022] Open
Abstract
A 78-year-old man, who had undergone lumboperitoneal shunt (LPS) placement for idiopathic normal-pressure hydrocephalus eight years prior, presented with intermittent claudication, lower back pain, and radicular pain on the inside of the right thigh. Magnetic resonance imaging (MRI) revealed an extradural arachnoid cyst (EDAC) above the lumbar catheter of the LPS. The EDAC compressed the spinal dural sac and cauda equina toward the anterior side at level L3/4, triggering his clinical manifestations. The LPS was removed and simultaneously converted into a ventriculoperitoneal shunt (VPS), which immediately improved the neurological deficits. Postoperative MRI showed shrinkage of the cyst and restoration of the compressed cauda equina. Spinal EDAC is a rare entity resulting from arachnoid membrane herniation due to a small defect in the dura mater. This is the first report showing that symptomatic EDAC can be accompanied by the lumbar catheter of the LPS and that a mere conversion from LPS to VPS or ventriculoatrial shunt might be sufficient to shrink LPS-related EDAC without invasive lumbar surgeries.
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Affiliation(s)
- Daisuke Kita
- Department of Neurosurgery, Noto General Hospital, Nanao, Ishikawa, Japan
| | - Yuya Yoshida
- Department of Neurosurgery, Noto General Hospital, Nanao, Ishikawa, Japan
| | - Fumihide Enkaku
- Department of Neurosurgery, Noto General Hospital, Nanao, Ishikawa, Japan
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Zanon IDB, Kanas M, Joaquim MAS, Martins DE, Wajchenberg M, Astur N. Posttraumatic Arachnoid Cyst in the Thoracic Spine with Medullary Compression: Case Report. Rev Bras Ortop 2021; 56:114-117. [PMID: 33627910 PMCID: PMC7895629 DOI: 10.1055/s-0040-1714225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 05/05/2020] [Indexed: 11/10/2022] Open
Abstract
Arachnoid cysts are rare; they can occur at all levels of the dural sac, and can have a congenital, traumatic, iatrogenic or inflammatory origin. In the present article, we report a patient presenting a compressive thoracic myelopathy due to an unusual intradural arachnoid cyst with posttraumatic manifestation and its resolution, in addition to a literature review on the subject. These cysts mainly occur at the thoracic spine, followed by the lumbar, lumbosacral and thoracolumbar spines. Traumatic cysts are caused by an injury to the inner dural layer. These lesions produce neurological deficits through a mass effect on the spinal cord. Concomitant compressive myelopathy is even rarer. In case of myelopathy, cyst resection or drainage is the treatment of choice, and it must be performed immediately. Although rare, arachnoid cysts can be a complication of spine fractures; as such, orthopedists and neurosurgeons, who commonly see these injuries, must be prepared for this unusual situation.
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Affiliation(s)
- Igor de Barcellos Zanon
- Grupo de Coluna Vertebral, Departamento de Ortopedia e Traumatologia "Pavilhão Fernandinho Simonsen", Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil
| | - Michel Kanas
- Departamento de Ortopedia e Traumatologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
| | | | - Délio Eulálio Martins
- Departamento de Ortopedia e Traumatologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
| | - Marcelo Wajchenberg
- Departamento de Ortopedia e Traumatologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
| | - Nelson Astur
- Grupo de Coluna Vertebral, Departamento de Ortopedia e Traumatologia "Pavilhão Fernandinho Simonsen", Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil.,Departamento de Ortopedia e Traumatologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
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Yoo KH, Kim MC, Ju CI, Kim SW. Extradural Spinal Arachnoid Cyst as a Cause of Cauda Equina Syndrome in a Child. Korean J Neurotrauma 2020; 16:355-359. [PMID: 33163450 PMCID: PMC7607013 DOI: 10.13004/kjnt.2020.16.e35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 08/24/2020] [Accepted: 09/23/2020] [Indexed: 11/15/2022] Open
Abstract
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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Affiliation(s)
- Kyoung Hwan Yoo
- Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea
| | - Min Chan Kim
- Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea
| | - Chang Il Ju
- Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea
| | - Seok Won Kim
- Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea
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Jiménez Zapata HD, Utiel Monsálvez E, Jiménez Arribas P, Dueñas Carretero M, Sánchez Fernández C, Fernández García A, Ayuso Hernández M, Rodríguez Arias CA. Compresión medular secundaria a quiste aracnoideo intradural de etiología traumática. Neurocirugia (Astur) 2020; 31:195-200. [DOI: 10.1016/j.neucir.2019.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/31/2019] [Indexed: 12/23/2022]
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Schmutzer M, Tonn JC, Zausinger S. Spinal intradural extramedullary arachnoid cysts in adults-operative therapy and clinical outcome. Acta Neurochir (Wien) 2020; 162:691-702. [PMID: 31813001 DOI: 10.1007/s00701-019-04156-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 11/25/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Spinal arachnoid cysts (SAC) are rare mostly idiopathic intradural lesions with compression of the spinal cord and clinical signs of radiculo- and/or myelopathy. We retrospectively analyzed radiological and clinical characteristics of patients with surgical treatment of SAC including a subgroup evaluation of long-term outcome and QoL. METHOD Patients with SAC treated between 1993 and 2017 were evaluated. Craniocaudal (c.c.) and anteroposterior (a.p) cyst diameters were measured pre- and post-OP. McCormick and Odom score for myelopathy, general outcome and QoL (SF-36, EORTC-QLQ30) were recorded. RESULTS A total of 72 patients (female:male = 1.9:1) were analyzed with mean FU of 44.8 ± 60 months (long-term data from 25 patients with FU 78.2 ± 63.9 months). All had surgery due to solitary cysts: 10 cervical (13.9%), 45 thoracic (62.5%), and 17 lumbosacral (23.6%), the majority (79.2%) located dorsally. Main symptoms were gait disturbance (80%), dysesthesia (64%) and paresis (80%). Patients had (hemi-)laminectomy with cyst fenestration in 48 (66.7%) and complete resection in 18 cases (25.0%). Four cases (5.5%) were treated by cystoperitoneal shunt, 2 by marsupialization (2.8%). In total, 11 revisions were necessary in 9/72 (12.5%) patients (one patient underwent 3 revisions). Two patients were reoperated for wound revision/epidural hematoma (each n = 1). Seven patients needed additional cyst wall resection after 1.5-31.0 months due to insufficient cyst shrinking and persistent clinical symptoms after first surgery; most of the cysts were multiple septated and of post-hemorrhagic origin. The mean c.c. size decreased from 5.2 ± 3.7 cm pre-OP to 2.7 ± 3.9 cm (p < 0.05); the a.p. diameter decreased from 1.0 ± 0.5 cm to 0.3 ± 0.3 cm (p < 0.0001) without significant differences between fenestration and resection. McCormick and Odom scores revealed improved symptoms, particularly of gait disturbance, sensory deficits, and general performance. Long-term FU displayed satisfying QoL performance without differences of fenestration or resection. CONCLUSION SAC mostly affect women and are predominantly located in the thoracic spine, becoming apparent with clinical myelopathy. For cysts without intracystic septae and compartments, both fenestration and resection of the cyst wall provided significant reduction of cyst size and clinical improvement.
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Traumatic spinal extradural arachnoid cyst—A case report. INTERDISCIPLINARY NEUROSURGERY 2019. [DOI: 10.1016/j.inat.2019.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Surgical Management of Spinal Arachnoid Cysts in Adults. World Neurosurg 2019; 122:e1146-e1152. [DOI: 10.1016/j.wneu.2018.11.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 10/29/2018] [Accepted: 11/02/2018] [Indexed: 02/06/2023]
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12
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Singh S, Bhaisora KS, Sardhara J, Das KK, Attri G, Mehrotra A, Srivastava AK, Jasiwal AK, Behari S. Symptomatic extradural spinal arachnoid cyst: More than a simple herniated sac. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE 2019; 10:64-71. [PMID: 31000984 PMCID: PMC6469322 DOI: 10.4103/jcvjs.jcvjs_12_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Introduction and Study Design: Spinal arachnoid cyst is an uncommon entity, presenting with radiculopathy or paraparesis. These cysts are usually found in intradural extramedullary region; and the extradural region is a rare location. The exact pathogenesis in the existence of these cysts in the extradural region is still debated. In this article, we have retrospectively analyzed the clinical profile of the rare extradural arachnoid cyst (EDAC). Methodology: In this study, 19 patients of EDAC operated at our institute between January 2006 to June 2016 are analyzed. All patients with the Oswestry disability index score of >20 were managed surgically (open laminectomy and cyst excision). The clinical outcome was assessed at using 5-point satisfaction scale and McCormick grading. Results: All 13 operated patients had EDACs with communication with the intradural compartment. In 11 (84.6%) patients, cyst wall was excised completely, in 2 (15.3%) patients underwent partial excision of cyst wall; dural communication was closed in all patients (n = 13). None of the patients had clinical deterioration or radiological recurrence till the last follow-up. Mean follow-up was 52.2 months (range 1–160); all patients were satisfied after surgery (median score was 3). Discussion: Symptomatic EDACs account <2% of all spinal tumors. The EDACs have communication with the intradural compartment. In our article, we have discussed the approach and management of EDAC, including minimally invasive percutaneous procedures. Conclusion: One should aim for preoperative or intraoperative localization of dural communication and try to disconnect the extradural cyst from the intradural connection to prevent recurrence. Surgical treatment is complete excision of the cyst.
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Affiliation(s)
- Suyash Singh
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Kamlesh Singh Bhaisora
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Jayesh Sardhara
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Kuntal Kanti Das
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Gagandeep Attri
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Anant Mehrotra
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Arun Kumar Srivastava
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Awadesh Kumar Jasiwal
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sanjay Behari
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Tirrito F, Lombardo R, Matiasek K, Rosati M, Cozzi F. Extradural meningeal cystic lesion corresponding to type I meningeal cyst in a dog. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2018-000659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Rocco Lombardo
- Clinica Neurologica Veterinaria NVAMilanItaly
- Department VESPAUniversity of MilanMilanItaly
| | - Kaspar Matiasek
- Center for Clinical Veterinary MedicineInstitute of Veterinary PathologyLudwig‐Maximilians‐University MunichMunichGermany
| | - Marco Rosati
- Center for Clinical Veterinary MedicineInstitute of Veterinary PathologyLudwig‐Maximilians‐University MunichMunichGermany
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Tanaka T, Boddepalli RS, Miller DC, Cao Z, Sindhwani V, Coates JR, Govindarajan R, Litofsky NS. Electrodiagnostic and Advanced Neuroimaging Characterization for Successful Treatment of Spinal Extradural Arachnoid Cyst. World Neurosurg 2018; 109:298-303. [DOI: 10.1016/j.wneu.2017.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 10/01/2017] [Accepted: 10/03/2017] [Indexed: 12/14/2022]
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Arenaza Basterrechea N, Macarrón Vicente J, Aícua Rapún I, Porqueres Bosch E. Quistes aracnoideos espinales, una causa inusual de cefalea de esfuerzo. Neurologia 2016; 31:579-80. [DOI: 10.1016/j.nrl.2014.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 10/16/2014] [Accepted: 10/31/2014] [Indexed: 10/24/2022] Open
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Arenaza Basterrechea N, Macarrón Vicente J, Aícua Rapún I, Porqueres Bosch E. Spinal arachnoid cysts as an unusual cause of exercise headache. NEUROLOGÍA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.nrleng.2014.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Sacral extradural arachnoid cyst in association with split cord malformation. Spine J 2016; 16:1109-15. [PMID: 27256785 DOI: 10.1016/j.spinee.2016.05.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 05/25/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Split cord malformation (SCM) is a congenital disease that can be associated with other spinal anomalies. Few cases of concurrent intradural arachnoid cyst and SCM have been sporadically reported; however, sacral extradural arachnoid cyst (SEAC) with SCM is very rare. PURPOSE The report describes our experience with simultaneous surgery in patients with concurrent SEAC and SCM in an effort to document the treatment of the rare spinal concomitant anomalies. STUDY DESIGN The present study is designed as a case series. PATIENT SAMPLE This is a continuous series of patients with coexisting SCM and SEAC who were presented to our institution. OUTCOME MEASURES The lower extremities weakness and deformity, radiological imaging, urodynamic tests, and surgical aspects of the patient population are documented. METHODS Cases with concomitant anomalies were consecutively enrolled among 73 patients who were operated on for SCM between 2008 and 2014. Clinical data and surgical findings were prospectively filed and retrospectively evaluated. RESULTS There were seven patients (2 boys and 5 girls), with age ranging from 18 to 119 months (mean: 56.71±39.49). Type I SCM was detected in six cases, and type II SCM was detected in one case. Tethering of the cord was detected in all seven patients, and six patients (85.7%) had syrinx formation rostral to the level of SCM. All patients had at least one kind of urological dysfunctions manifesting as neurogenic bladder. On surgery, fistulous orifice of the meningeal cyst was found and ligated in six cases, and the other one was repaired via sealing the cyst walls as near as possible to the thecal sac. CONCLUSIONS In patients with symptomatic SCM, the signs of concurrent SEAC may be masqueraded by the former condition. It would be impossible to attribute a given sign, particularly urological signs, to either SCM or SEAC. Whatever the sign and nature, both conditions are better to be managed surgically in one session under a single anesthesia to prevent duplicate complications of further anesthesia and interventions in scar tissue.
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Jin B, Zhao JZ, Wang HB, Wang KD, Liu LQ, Su YB. Laminectomy by craniotome for huge spinal extradural arachnoid cyst: a case report. Chin Neurosurg J 2016. [DOI: 10.1186/s41016-016-0034-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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