Diagnosis and treatment of spinal extradural arachnoid cysts: A chronic traumatic case report with review of the literature: Spinal extradural arachnoid cysts

Hümeyra  Kullukçu; Ahmet Gürhan  Gürçay; Atilla  Kazancı; Oktay  Gürcan; Mehmet Özgür  Özateş

doi:10.28982/josam.1073804

Authors

Hümeyra Kullukçu Medical Park Ankara Hospital, Department of Neurosurgery, Ankara, Turkey https://orcid.org/0000-0003-0675-8288
Ahmet Gürhan Gürçay Yıldırım Beyazıt University, Faculty of Medicine, Department of Neurosurgery, Ankara, Turkey https://orcid.org/0000-0002-8810-938X
Atilla Kazancı Yıldırım Beyazıt University, Faculty of Medicine, Department of Neurosurgery, Ankara, Turkey https://orcid.org/0000-0001-8975-9694
Oktay Gürcan Yıldırım Beyazıt University, Faculty of Medicine, Department of Neurosurgery, Ankara, Turkey https://orcid.org/0000-0002-2726-0043
Mehmet Özgür Özateş Yıldırım Beyazıt University, Faculty of Medicine, Department of Neurosurgery, Ankara, Turkey https://orcid.org/0000-0002-2051-7766

DOI:

https://doi.org/10.28982/josam.1073804

Keywords:

arachnoid cysts, spinal, extradural, trauma

Abstract

Arachnoid cysts are formed by duplication of the arachnoid membrane between the arachnoid and the pia mater. Although it is very common in intracranial localization, those with spinal location are rare. Extradural arachnoid cysts of the spinal canal are extremely rare pathologies regarded as either congenital or acquired. These cysts, which can develop idiopathic, post-traumatic, and after arachnoiditis, are often detected incidentally. They present with weakness in the extremities, neuropathic pain, paresthesia, or myelopathy. Here we describe the case of a 17-year-old male patient with a history of chronic spinal trauma who attended our clinic with severe low back pain for 7 months.

Downloads

Download data is not yet available.

References

Lee HJ, Cho DY. Symptomatic spinal intradural arachnoid cysts in the pediatric age group: description of three new cases and review of the literature. Pediatr Neurosurg. 2001;35:181–187. doi: 10.1159/000050419. DOI: https://doi.org/10.1159/000050419

Kim IS, Hong JT, Son BC, Lee SW. Noncommunicating spinal extradural meningeal cyst in thoracolumbar spine. J Korean Neurosurg Soc. 2010;48:534-7. doi: 10.3340/jkns.2010.48.6.534. DOI: https://doi.org/10.3340/jkns.2010.48.6.534

Liu JK, Cole CD, Sherr GT, Kestle JR, Walker ML. Noncommunicating spinal extradural arachnoid cyst causing spinal cord compression in a child. J Neurosurg. 2005;103[3 Suppl]:266-9. doi: 10.3171/ped.2005.103.3.0266. DOI: https://doi.org/10.3171/ped.2005.103.3.0266

Khan SS, Ahmed N, Chaurashia B, Ahsan K. Diagnosis and treatment of noncommunicating extradural spinal thoracolumbar arachnoid cyst. Surg Neurol Int. 2020 Nov 25;11:405. doi: 10.25259/SNI_579_2020. DOI: https://doi.org/10.25259/SNI_579_2020

Rengachary SS, Wilkins RH, Mc Graw Hill. Spinal arachnoid cycts. Neurosurgery, New York 1985:2068-9.

Wang MY, Levi AD, Green BA. Intradural spinal arachnoid cysts in adults. Surg Neurol. 2003;60[1]:49-56. doi: 10.1016/s0090-3019[03]00149-6. DOI: https://doi.org/10.1016/S0090-3019(03)00149-6

Malformations of the central nervous system. In: Aicardi J. Diseases of the Nervous System in Childhood. 2nd Ed. London: Mac Keith Press.1998. p. 69-130.

Spiller WG, Musser JH, Martin E. A case of intradural spinal cyst with operation and recovery; with a brief report of eleven cases of tumor of spinal cord or spinal column. Trans Stud Coll Physicians Philad 1903;25:1–18.

Spigelmann R, Rappaport ZH, Sahar A. Spinal arachnoid cyst with unusual presentation. J Neurosurg. 1984;60:613-6. doi: 10.3171/jns.1984.60.3.0613. DOI: https://doi.org/10.3171/jns.1984.60.3.0613

Nabors MW, Pait TG, Byrd EB, Karim NO, Davis DO, Kobrine AI, et al. Updated assessment and current classification of spinal meningeal cysts. J Neurosurg. 1988;68:366-77. doi.org/10.3171/jns.1988.68.3.0366. DOI: https://doi.org/10.3171/jns.1988.68.3.0366

McCrum C, Williams B. Spinal extradural arachnoid pouches. J Neurosurg. 1982;57:849-52. doi: 10.3171/jns.1982.57.6.0849. DOI: https://doi.org/10.3171/jns.1982.57.6.0849

Agnoli AL, Schonmayr R, Laun A. Intraspinal arachnoid cysts. Acta Neurochir [Wien]. 1982;61(2):291-3. doi: 10.1007/BF01743873. DOI: https://doi.org/10.1007/BF01743873

Gonzales MG, Prieto JMC, Allut AG. Spinal arachnoid cyst without neural tube defect. Child Nerv Syst. 2001;17[2]:179-8. doi: 10.1007/s003810000367. DOI: https://doi.org/10.1007/s003810000367

Kong WK, Cho KT, Hong SK. Spinal extradural arachnoid cyst: A case report. Korean J Spine. 2013;10:32-4. doi: 10.14245/kjs.2013.10.1.32. DOI: https://doi.org/10.14245/kjs.2013.10.1.32

French H, Biggs M, Parkinson J, Allan R, Ball J, Little N. Idiopathic intradural dorsal thoracic arachnoid cysts: a case series and review of the literature. J Clin Neurosci. 2017;40:147–52. doi: 10.1016/j.jocn.2017.02.051. DOI: https://doi.org/10.1016/j.jocn.2017.02.051

Perret G, Green D, Keller J. Diagnosis and treatment of intradural arachnoid cysts of the thoracic spine. Radiology. 1962;79:425–9. doi: 10.1148/79.3.425. DOI: https://doi.org/10.1148/79.3.425

Haney A, Stiller J, Zelnik N, Goodwin L. Association of post-traumatic spinal arachnoid cyst and syringomyelia. J Comput Tomogr. 1985;9[1]:137-4. doi: 10.1016/0149-936x[85]90008-6. DOI: https://doi.org/10.1016/0149-936X(85)90008-6

Funao H, Nakamura M, Hosogane N, Watanabe K, Tsuji T, Ishii K, et al. Surgical treatment of spinal extradural arachnoid cysts in the thoracolumbar spine. Neurosurgery. 2012;71:278-84. doi: 10.1227/NEU.0b013e318257bf74. DOI: https://doi.org/10.1227/NEU.0b013e318257bf74

Bassiouni H, Hunold A, Asgari S, Hübschen U, König HJ, Stolke D. Spinal intradural juxtamedullary cysts in the adult: surgical management and outcome. Neurosurgery. 2004;55:1352–1360. doi: 10.1227/01.neu.0000143031.98237.6d. DOI: https://doi.org/10.1227/01.NEU.0000143031.98237.6D

Fam MD, Woodroffe RD, Helland L, Noeller J, Dahdaleh NS, Menezes AH, et al. Spinal arachnoid cysts in adults: diagnosis and management. A single-center experience. J Neurosurg Spine. 2018;29:711–719. doi: 10.3171/2018.5.SPINE1820. DOI: https://doi.org/10.3171/2018.5.SPINE1820

Garg K, Borkar SA, Kale SS, Sharma BS. Spinal arachnoid cysts- our experience and review of literature. British Journal of Neurosurgery. 2016;1-7. doi: 10.1080/02688697.2016.1229747. DOI: https://doi.org/10.1080/02688697.2016.1229747

Bond AE, Zada G, Bowen I, McComb JG, Krieger MD, et al. Spinal arachnoid cysts in the pediatric population: report of 31 cases and a review of the literature. J Neurosurg Pediatr. 2012;9:432–41. doi: 10.3171/2012.1.PEDS11391. DOI: https://doi.org/10.3171/2012.1.PEDS11391

Netra R, Min L, Shao Hui M, Wang JC, Bin Y, Ming Z. Spinal extradural meningeal cysts: An MRI evaluation of a case series and literature review. J Spinal Disord Tech. 2011;24:132-6. doi: 10.1097/BSD.0b013e3181e47b47. DOI: https://doi.org/10.1097/BSD.0b013e3181e47b47

Singh S, Bhaisora KS, Sardhara J, Das KK, Attri G, Mehrotra A, et al. Symptomatic extradural spinal arachnoid cysts: More than a simple herniated sac. J Craniovert Jun Spine. 2019;10:64-71. doi: 10.4103/jcvjs.JCVJS_12_19. DOI: https://doi.org/10.4103/jcvjs.JCVJS_12_19

Viswanathann VK, Manoharan SR, Do H, Minnema A, Shaddy SM, Elder JB. Clinical and radiologic outcomes after fenestration and partial wall excision of idiopathic intradural spinal arachnoid cysts presenting with myelopathy. World Neurosurg. 2017;105:213–22. doi: 10.1016/j.wneu.2017.05.136. DOI: https://doi.org/10.1016/j.wneu.2017.05.136

Hatashita S, Kondo A, Shimizu T, Kurosu A, Ueno H. Spinal extradural arachnoid cyst-case report. Neurol Med Chir 2001;41:318–21. doi: 10.2176/nmc.41.318. DOI: https://doi.org/10.2176/nmc.41.318

Neo M, Koyama T, Sakamoto T, Fujibayashi S, Nakamura T. Detection of a dural defect by cinematic magnetic resonance imaging and its selective closure as a treatment for a spinal extradural arachnoid cyst. Spine. 2004;29:E426–30. doi: 10.1097/01.brs.0000141189.41705.70. DOI: https://doi.org/10.1097/01.brs.0000141189.41705.70

Endo T, Takahashi T, Jokura H, Tominaga T. Surgical treatment of spinal intradural arachnoid cysts using endoscopy. J Neurosurg Spine. 2010;12:641–6. doi: 10.3171/2009.12.SPINE09577. DOI: https://doi.org/10.3171/2009.12.SPINE09577

Tokmak M, Ozek E, Iplikcioglu AC. Spinal extradural arachnoid cysts: A series of 10 cases. hJ Neurol Surg A Cent Eur Neurosurg. 2015;76:348-52. doi: 10.1055/s-0035-1547360. DOI: https://doi.org/10.1055/s-0035-1547360