Arachnoiditis ossificans with progressive syringomyelia and spinal arachnoid cyst

Papavlasopoulos, F.; Stranjalis, Georgios; Kouyialis, Andreas T.; Korfias, Stefanos; Sakas, Damianos E.

doi:10.1016/j.jocn.2006.02.024

Cited by 36 publications

(24 citation statements)

References 25 publications

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“…The number of the reported patients who were either treated surgically or with aspiration of the cyst under MRI guidance was 74. Most cases included idiopathic cysts [4,6,12,14,16,20,23,24,28,[30][31][32]. Jea et al reported the formation of an arachnoidal cyst as a complication after syringo-subarachnoid shunt operation in syringomyelia.…”

Section: Discussionmentioning

confidence: 99%

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Spinal cord compression caused by idiopathic intradural arachnoid cysts of the spine: review of the literature and illustrated case

et al. 2009

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Intradural spinal arachnoid cysts with cord compression are rare. When becoming symptomatic they cause variable symptoms involving gait disturbance, paraparesis or tetraparesis and neuropathic pain, decreasing significantly the patients' life quality. The extension of such cysts averages 3.7 vertebral bodies. The diagnosis is clinical and radiological with the use of MRI, CT myelography or a combination of both. The best treatment option is complete removal of the cyst. However, even when paresis is regressing there is no good recovery from neuropathic pain. Laminectomy approach can cause postoperative complications especially when the cyst(s) expand(s) in more than one level. Alternatively, a cyst fenestration can be performed, including the levels of the maximal spinal cord compression. The clinical outcome is as good as after the cyst resection enabling the patient to walk again. The neuropathic pain may persist and require medication. A clinical case is presented, and the literature is reviewed. In the present case we report a patient with intradural arachnoid cysts extending from T6 to L2 and causing severe gait ataxia as well as neuropathic pain and hypaesthesia. The spinal-cord was compressed at T8 and T12. Surgical treatment with partial cyst resection in the compressed levels with an interlaminar approach brought similar results as complete resection. The patient was able to walk without help which was not possible before surgery. The cysts' extension is impressive as well as the minimal operative procedure.

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Section: Discussionmentioning

confidence: 99%

“…The first search for arachnoid spinal cysts revealed 105 results (out of 500), including multiple extradural arachnoidal cysts and arachnoiditis, as a complication of infection [20], or formation of cysts as a complication of haematomas or surgery [9]. In our search we excluded children with other neural tube deformities.…”

Section: Literature Reviewmentioning

confidence: 99%

Spinal cord compression caused by idiopathic intradural arachnoid cysts of the spine: review of the literature and illustrated case

et al. 2009

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“…Syringomyelia due to a spinal arachnoid cyst is quite rare and there is no information regarding its incidence. A total of 31 cases have been reported so far (1, 4, 7-9, 13,18,20,24,26,31,32,34,35). An arachnoid cyst of thoracic localization is reported most commonly but other localizations are also present.…”

Section: Case Reportmentioning

confidence: 99%

Spinal arachnoid cysts associated with syringomyelia: a review of the literature and report of a case

Tucer

Yılmaz²,

Ekici³

et al. 2014

Turkish Neurosurgery

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Syringomyelia is a not infrequent pathology that develops related to changes in cerebrospinal fluid dynamics due to many etiological factors. The development of syringomyelia through a spinal arachnoid cyst is quite rare and has been defined in only 31 cases in the literature. A case due to thoracic epidural lipomatosis has also been reported. There have been no previous reports of thoracic region epidural lipomatosis with underlying arachnoid cyst and syringomyelia as in our case. We present a 27-year-old patient who developed thoracic arachnoid cyst and underlying syringomyelia because of the pressure of the thoracic epidural fat tissue and also evaluate the characteristics of patients with syringomyelia by virtue of an arachnoid cyst previously reported in the literature. KEywORDS: Epidural lipomatosis, Spinal arachnoid cyst, Syringomyelia, Surgical treatment ÖZSiringomyeli, birçok etiyolojik faktörden kaynaklanan serebrospinal sıvı dinamiğindeki değişikliklerle ilgili olarak gelişen, nadir olmayan bir patolojidir. Spinal araknoid kistin sebep olduğu siringomyeli gelişimi oldukça nadirdir ve literatürde yalnızca 31 olguda tanımlanmıştır. Ayrıca torakal epidural lipomatozisten kaynaklanan olgu da rapor edilmiştir. Bizim olgumuzdaki gibi torakal bölge epidural lipomatozis ile altında yatan araknoid kist ve siringomyeli daha önce rapor edilmemiştir. Biz, torakal epidural yağ basısından dolayı torakal araknoid kist ve altında yatan siringomyelisi olan 27 yaşında bir hasta sunuyoruz. Ayrıca daha önce literatürde rapor edilmiş araknoid kist nedeniyle oluşan siringomyelili hastaların özelliklerini değerlendiriyoruz.

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“…Arachnoid calcifications have been found in autopsy studies with a reported incidence of 6.5-76% [1][2][3][4], though few reports have identified the co-existence of arachnoid calcifications with intrathecal cysts [5,6]. Even fewer reports associate these plaques with compressive intrathecal cysts causing neurologic compromise.…”

Section: Introductionmentioning

confidence: 99%

Arachnoid ossificans containing metaplastic hematopoietic marrow resulting in diffuse thoracic intrathecal cysts and severe myelopathy

Abrams

Mindea

et al. 2011

Eur Spine J

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Objective To present a rare case of multiple compressive thoracic intradural cysts with pathologic arachnoid ossification, review the literature and present the surgical options. Summary of background data Few reports have identified the existence of arachnoid calcifications and intrathecal cysts causing progressive myelopathy. The literature regarding each of these pathologies is limited to case reports. Their clinical significance is not well studied, although known to cause neurologic sequelae. Methods An 81-year-old female clinically presents with rapidly progressive myelopathy. Pre-operative magnetic resonance imaging identified multiple compressive thoracic intrathecal cysts. Surgical exploration and decompression of these cysts identified calcified plaques within the arachnoid. Histopathologic examination revealed fibrocalcific tissue undergoing ossification with bone marrow elements. Results Due to progressive myelopathy, the thoracic cysts were decompressed and calcified plaques were excised, once identified intra-operatively. Conclusions On last examination, the patient's neurologic status had not improved, but had stabilized. The rate of neurologic improvement from excision and decompression is variable, but it may still be warranted in the face of progressive neurologic deficits.

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Arachnoiditis ossificans with progressive syringomyelia and spinal arachnoid cyst

Cited by 36 publications

References 25 publications

Spinal cord compression caused by idiopathic intradural arachnoid cysts of the spine: review of the literature and illustrated case

Spinal cord compression caused by idiopathic intradural arachnoid cysts of the spine: review of the literature and illustrated case

Spinal arachnoid cysts associated with syringomyelia: a review of the literature and report of a case

Arachnoid ossificans containing metaplastic hematopoietic marrow resulting in diffuse thoracic intrathecal cysts and severe myelopathy

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