Intraoperative Visualization of a Spinal Arachnoid Cyst Using Pyoktanin Blue

Takamiya, Soichiro; Seki, Takahiro; Yamazaki, Kazuyoshi; Sasamori, Toru; Houkin, Kiyohiro

doi:10.1016/j.wneu.2017.09.031

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…The 34 included articles yielded 271 cases of spinal intradural arachnoid cysts that underwent surgical intervention. 6,8-40 An additional 22 patients were added from our institution providing a total of 293 cases. For the entire cohort, the mean age was 51.4 years (range 19-91 years).…”

Section: Resultsmentioning

confidence: 99%

“…Case series have demonstrated improved clinical outcomes irrespective of the technique used for bony removal or cyst management. 6,8-40 Regarding dural closure, Moses et al 11 found that duraplasty afforded a significant reduction in postoperative pain compared with primary dural closure with running suture in a cohort of 21 patients with spinal intradural arachnoid cysts. In our practice, we use an open microsurgical approach, wide-based laminectomies, cyst fenestration, and primary dural closure for these lesions.…”

Section: Discussionmentioning

confidence: 99%

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Spinal Intradural Arachnoid Cysts in Adults: An Institutional Experience and Literature Review

et al. 2022

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BACKGROUND:Adult spinal intradural arachnoid cysts are rare pathologic entities with an unclear etiopathogenesis. These lesions can be dichotomized into primary (idiopathic) or secondary (related to inflammation, intradural surgery, or trauma) etiologies. Limited series have depicted optimal management strategies and clinical outcomes.OBJECTIVE:To illustrate our experience with spinal intradural arachnoid cysts and to present a literature review of surgically treated cysts to elucidate the clinical and anatomic differences between etiologies.METHODS:Institutional review revealed 29 patients. Various data were extracted from the medical record. Initial and follow-up symptomatologies of the surgical cohort were compared. The literature review included case series describing cysts managed surgically.RESULTS:From patients treated surgically at our institution (22), there was a significant reduction in thoracic back pain postoperatively (P = .034). A literature review yielded 271 additional cases. Overall, primary and secondary lesions accounted for 254 and 39 cases, respectively. Cysts of secondary origin were more likely localized ventral to the spinal cord (P = .013). The rate of symptomatic improvement after surgical intervention for primary cysts was more than double than that of secondary cysts (P < .001). Compared with primary etiologies, the rates of radiographic progression (P = .032) and repeat surgery (P = .041) were each more than double for secondary cysts.CONCLUSION:Surgical intervention for spinal intradural arachnoid cysts improves thoracic back pain. The literature supports surgical intervention for symptomatic primary spinal intradural arachnoid cysts with improved clinical outcomes. Surgery should be cautiously considered for secondary cysts given worse outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Spinal Intradural Arachnoid Cysts in Adults: An Institutional Experience and Literature Review

et al. 2022

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“…Mishra et al demonstrated intraoperative dynamic magnetic resonance myelogram for detecting the site of the fistula [11]. Gu et al used digital subtraction cystography to detect a communicating hole between a cyst and the subarachnoid space [12], and Takamiya et al injected pyoktanin blue into spinal arachnoid cysts to aid in total excision [13]. Endo et al offered the less invasive surgical method of endoscopic fenestration to manage spinal intradural arachnoid cysts [14].…”

Section: Discussionmentioning

confidence: 99%

Utilizing real-time contrast medium to detect the fistula of giant spinal arachnoid cyst and treat with minimal invasive surgery

et al. 2019

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BackgroundSpinal arachnoid cysts are rare and have varied clinical manifestations depending on the affected spinal region and nerve roots. A complete cyst excision with fistula closure is the first choice of treatment. However, it might be difficult to localize the specific position of the fistula because previous images have no enhancements or the fistula is too tiny to be detected.Case presentationThis case is a giant lumbar extradural arachnoid cyst. We administered a lumbar injection with contrast medium into subarachnoid space under digital subtraction angiography (DSA) and disclosed the fistula. Confirming the location of fistula enabled us to perform minimally invasive surgery to ligate the fistula. Surgical intervention for a spinal arachnoid cyst might encounter the problem of the formation of a postoperative cerebrospinal fluid (CSF) fistula. We propose the option of detecting the fistula preoperatively for minimal invasive surgery. Recurrence depends on the long-term follow-up, and more cases are needed to further evaluate our technique.ConclusionsThe real-time contrast medium technique for spinal arachnoid cysts contributes to the complete ligation with minimally invasive surgery.

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“…Pyoktanin blue (PB), 4-{bis [4-(dimethylamino) phenyl] methylidene}- N,N -dimethylcyclohexa-2,5-dien-1-iminium chloride (also known as crystal violet, methyl violet, or gentian violet) is a cationic dye used as a histological stain and visualization [ 1 , 2 , 3 , 4 ] and in Gram′s method of classifying bacteria [ 5 ] ( Figure 1 ). A paper on the selective bactericidal action of PB dates back to 1912 [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Re-Evaluation of Chemotherapeutic Potential of Pyoktanin Blue

et al. 2021

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Background: Pyoktanin blue (PB) is used for staining tissues and cells, and it is applied in photodynamic therapy due to its potent bactericidal activity. However, clinical application of PB as an antiviral and antitumor agent has been limited due to its potent toxicity. For clinical application, the antitumor and antiviral activity as well as the neurotoxicity of PB were re-evaluated with a chemotherapeutic index. Methods: Tumor-specificity (TS) was determined by the ratio of CC50 against normal oral cells/oral squamous cell carcinoma (OSCC); neurotoxicity by that of normal oral/neuronal cells; antiviral activity by that of mock-infected/virus-infected cells; and potency-selectivity expression (PSE) by dividing TS by CC50 (OSCC). Results: Antitumor activity of PB (assessed by TS and PSE) was comparable with that of DXR and much higher than that of 5-FU and melphalan. PB induced caspase-3 activation and subG1 cell accumulation in an OSCC cell line (Ca9-22). PB and anticancer drugs showed comparable cytotoxicity against both neuronal cells and OSCC cell lines. PB showed no detectable anti-HIV/HSV activity, in contrast to reverse transferase inhibitors, sulfated glucans, and alkaline extract of leaves of S.P. Conclusions: PB showed first-class anticancer activity and neurotoxicity, suggesting the importance of establishing the safe treatment schedule.

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Intraoperative Visualization of a Spinal Arachnoid Cyst Using Pyoktanin Blue

Cited by 3 publications

References 8 publications

Spinal Intradural Arachnoid Cysts in Adults: An Institutional Experience and Literature Review

Spinal Intradural Arachnoid Cysts in Adults: An Institutional Experience and Literature Review

Utilizing real-time contrast medium to detect the fistula of giant spinal arachnoid cyst and treat with minimal invasive surgery

Re-Evaluation of Chemotherapeutic Potential of Pyoktanin Blue

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