Abstract:
INTRODUCTION:Intradural spinal arachnoid cysts (SACs) are among many etiologies for syringomyelia. Consequentially, neurologic symptoms arise such as pain, gait disturbance, and bladder dysfunction. Identification of SAC on magnetic resonance imaging (MRI) can be challenging, as SACs can be fenestrated or in the form of fine webs. METHODS:Imaging and clinical data for 7 patients who underwent surgical treatment for SAC associated with syringomyelia were reviewed. All previous publications of this pathology were reviewed via MEDLINE search. RESULTS:Seven patients with a mean age 59 years were found to have a SAC causing syringomyelia. Intraoperative exploration confirmed SAC appearances of fine webs or a fluid-filled loculation impinging on the spinal cord. Common presentations were back pain, gait disturbance, and bladder incontinence. Diagnosis was made by MRI, although in 3 cases, the SAC was not identified on the initial review. Computed tomography myelogram was performed in one case due to the enlarged syringomyelia and lack of obvious spinal cord compression. Thoracic laminectomy/laminoplasty was performed for all patients, centered at the level of a subtle indentation of the cord; the syringomyelia proper was not directly addressed. Postoperatively, all patients had complete resolution of their symptoms with MRI demonstrating resolution of the syringomyelia. CONCLUSIONS:Careful evaluation of the MRI can demonstrate subtle indentation of the cord at the caudal or cephalad end of the syringomyelia and may obviate the need for additional imaging. Meticulous arachnoid dissection and establishment of good CSF flow is sufficient for resolution of the syringomyelia, averting the need for more aggressive procedures.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Srinivasan VM,Fridley JS,Thomas JG,Omeis Idoi
10.1016/j.wneu.2015.11.004subject
Has Abstractpub_date
2016-03-01 00:00:00pages
176-86eissn
1878-8750issn
1878-8769pii
S1878-8750(15)01518-1journal_volume
87pub_type
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journal_title:World neurosurgery
pub_type: 杂志文章
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pub_type: 历史文章,杂志文章,评审
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pub_type: 杂志文章,多中心研究
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journal_title:World neurosurgery
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
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pub_type: 杂志文章
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journal_title:World neurosurgery
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pub_type: 杂志文章
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.05.058
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pub_type: 杂志文章
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更新日期:2019-01-10 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2018-06-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2014.05.028
更新日期:2014-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:2011-05-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2016-08-01 00:00:00
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pub_type: 杂志文章
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