Multiple communicating intradural arachnoid cysts: usefulness of myelography and myelo-computed tomography using both lumbar and cervical punctures. Case report

Abstract

We report a case of multiple communicating intradural cystic lesions. Magnetic resonance imaging did not demonstrate the lesions. Neuroradiological diagnosis of the intradural arachnoid cysts was made from myelography and myelo-computed tomography using both lumbar and cervical punctures. These procedures give us useful information about flow dynamics in the spinal subarachnoid space.

Arachnoiditis associated with arachnoid cyst formation and cord tethering following myelography: Magnetic resonance features

“…Spinal arachnoid cysts are mostly congenital in origin. Acquired arachnoid cyst formation has been reported with myelography, arachnoiditis, meningitis, ankylosing spondylitis, trauma, extra‐axial tumours, tuberculosis and subdural haematomas 9–14 . These cysts are frequently associated with syrinx formation in the cord and/or cord atrophy.…”

“…Smaller arachnoid cysts can be confirmed with myelography and CT myelography but may not be obvious on MRI in the absence of mass effect. Multiple intercommunicating arachnoid cysts are also seen with arachnoiditis 10 …”

“…Acquired arachnoid cyst formation has been reported with myelography, arachnoiditis, meningitis, ankylosing spondylitis, trauma, extra-axial tumours, tuberculosis and subdural haematomas. [9][10][11][12][13][14] These cysts are frequently associated with syrinx formation in the cord and/or cord atrophy. Smaller arachnoid cysts can be confirmed with myelography and CT myelography but may not be obvious on MRI in the absence of mass effect.…”

Cervicothoracic Intradural Arachnoid Cyst Misdiagnosed as Motor Neuron Disease

“…Some lesions may elude diagnosis due to the similar MRI signal of the cyst compared with adjacent subarachnoid spaces. Myelography and myelocomputed tomography may occasionally be more sensitive and provide information on CSF flow dynamics [6]. In our case, neither the cystic cavity nor its membrane or mass effect was detected by the first radiological workup that comprised cranial but no spinal MRI.…”

“…To date, approximately 100 cases have been reported, with the majority (95%) occurring in the thoracic or cervical section, only exceptionally exceeding a length of three vertebral bodies [2]. MRI is the diagnostic procedure of first choice [5, 6]. Some lesions may elude diagnosis due to the similar MRI signal of the cyst compared with adjacent subarachnoid spaces.…”