Spinal extradural arachnoid cysts

Rahimizadeh, Abolfazl; Kaghazchi, Mahmud; Shariati, Majid; Abdolkhani, Eidi; Abbasnejad, Enayatolah; Rahimizadeh, Shaghayegh

doi:10.1590/s1808-18512013000200004

Cited by 4 publications

(11 citation statements)

References 51 publications

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“…Stop nio we ich po więk sza nie się mo że po wo do wać ucisk rdze nia krę go we go i być przy czyną po stę pu ją ce go nie do wła du lub po ra że nia kk dolnych. Tor bie le pa ję czy nów ki sta ją się ob ja wo we po dłu gim okre sie kli nicz nej sta bil no ści i wów czas wyma ga ją le cze nia ope ra cyj ne go [14][15][16][17][18].…”

Section: Discussionunclassified

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Brachial Plexus Root Avulsion Injury with Occipital Condyle Fractures. Case Study

Baranowska¹,

Baranowska

Pydych

et al. 2016

Ortop Traumatol Rehabil

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STRESZCZENIEAwulsyjne uszkodzenie splotu ramiennego ze złamaniem kłykcia potylicznego należy do bardzo rzadkich urazów i najczęściej jest skutkiem wypadków komunikacyjnych. W pracy przedstawiono analizę przypadku 24-letniego pacjenta, u którego w wyniku wypadku samochodowego wystąpiły obydwa powyższe uszkodzenia. Badanie tomografii komputerowej uwidoczniło złamanie kłykcia potylicznego prawego, natomiast badanie rezonansu magnetycznego przerwanie ciągłości nerwów rdzeniowych na poziomie C3-C7 po stronie lewej. U chorego zastosowane leczenie zachowawcze.Słowa kluczowe: uszkodzenie splotu ramiennego, złamania kłykcia potylicznego, rezonans magnetyczny SUMMARYAvulsion injuries of the brachial plexus with occipital condyle fractures are very rare and usually result from motor vehicle accidents. This paper presents an analysis of the case of a 24-year-old male patient who sustained both these injuries in a car accident. Computed tomography revealed a fracture of the right occipital condyle and a magnetic resonance scan showed spinal nerve disruption at the C3-C7 level on the left. The patient underwent conservative treatment. MEDSPORTPRESS, 2016; 4(6); Vol. 18, 359-365 DOI: 10.5604/15093492.1220827 Key words: brachial plexus injuries , occipital condyle fractures, magnetic resonance imaging STUDIUM PRZYPADKU / CASE STUDYO O r r t t o o p p e e d d i i a a Traumatologia Rehabilitacja © WSTĘPUszko dze nie splo tu ra mien ne go na stę pu je naj czę -ściej w wy ni ku ura zu, tj. wy pad ku ko mu ni ka cyj ne go z udzia łem po jaz dów po ru sza ją cych się z du żą pręd -ko ścią, upad ku z wy so ko ści, kon tu zji spor to wych oraz dłu go trwa łe go uci sku na splot ra mien ny np. pod czas snu. Spo śród wszyst kich wy pad ków ko mu ni ka cyj nych tyl ko 0,67% pro wa dzi do uszko dze nia splo tu ra mienne go. Naj czę ściej pro blem do ty czy gru py mło dych mę żczyzn po wy pad kach mo to cy klo wych [1,2]. Uraz o du żej in ten syw no ści w cza sie wy pad ku, po wo du ją -cy przy gię cie gło wy i szyi do bar ku, jest przy czy ną wy rwa nia ko rze ni ner wów rdze nio wych z rdze nia krę go we go stro ny prze ciw nej.Kon se kwen cją nad mier nej trak cji splo tu mo że być je go uszko dze nie przed zwo jo we lub po za zwo jowe. Uszko dze nie przed zwo jo we ozna cza uszko dzenie włó kien ner wo wych przed zwo jem rdze nio wym, w ka na le krę go wym lub w otwo rze mię dzy krę gowym [2][3][4]. Uszko dze nie to nie po wo du je de ge ne racji ty pu Wal le ria na i nie two rzą się ner wia ki, po nieważ ak son po zo sta je w cią gło ści z cia łem ko mór ki w zwo ju. Uszko dze nie po za zwo jo we okre śla uszkodze nie włó kien ner wo wych dy stal nie od zwo ju rdzenio we go i fi zjo lo gicz nie po dob ne jest do uszko dzenia ner wów ob wo do wych.Awul sja ko rze ni ner wów rdze nio wych pro wa dzi do po ra że nia splo tu ra mien ne go i jest spo wo do wa na wy so ko ener ge tycz nym na prę że niem włó kien nerwo wych. Zer wa ne włók na są nie zdol ne do re ge ne racji i nie pod da ją się le cze niu chi rur gicz ne mu, a de ficy ty...

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Section: Discussionunclassified

“…Their gradually increasing size may result in spi nal cord compression and cause progressive paresis or paralysis of the lower limbs. Arachnoid cysts require surgical treatment once they become symptoma tic after a long period of clinical stability [14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Brachial Plexus Root Avulsion Injury with Occipital Condyle Fractures. Case Study

Baranowska¹,

Baranowska

Pydych

et al. 2016

Ortop Traumatol Rehabil

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“…11,13 Spinal arachnoid cysts are usually discovered intradurally and are infrequently found extradurally, whereas an intramedullary arachnoid cyst remains an exception. [15][16][17] In extradural ones, prerequisite for the formation of the cyst is a dural defect that might be congenital or due to trauma. [4][5][6][7][8][9][10][11][12][13][14][15] In traumatic extradural arachnoid cysts, trauma is the cause of dural breach that allows outpouching of the arachnoid layer and its entrance into the extradural compartment.…”

Section: Discussionmentioning

confidence: 99%

“…[15][16][17] In extradural ones, prerequisite for the formation of the cyst is a dural defect that might be congenital or due to trauma. [4][5][6][7][8][9][10][11][12][13][14][15] In traumatic extradural arachnoid cysts, trauma is the cause of dural breach that allows outpouching of the arachnoid layer and its entrance into the extradural compartment. [8][9][10][11][12][13][14][15] With its gradual expansion via ball valve mechanism, the pouch becomes larger and ultimately shapes into an extradural arachnoid cyst.…”

Section: Discussionmentioning

confidence: 99%

“…The scenario of the arachnoid cyst formation and its subsequent enlargement is timely, becoming symptomatic only after a rather long period of clinical stability. [8][9][10][11][12][13][14][15] A trauma of sufficient intensity imposed to the angle between the neck and shoulder, dating to the time of the accident or during breach vaginal delivery, appears to be the most likely cause of both root avulsion and dura tear responsible for delayed development of the extradural spinal arachnoid cyst. 3 Imaging studies play an essential role in differentiating preganglionic injuries from postganglionic lesions, a differentiation that is crucial for determining the management of brachial plexus injuries.…”

Section: Discussionmentioning

confidence: 99%

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Remote Paraparesis due to a Traumatic Extradural Arachnoid Cyst Developing 2 Years after Brachial Plexus Root Avulsion Injury: Case Report and Review of the Literature

Rahimizadeh

Ehteshami

Yazdi³

et al. 2015

J Brachial Plex Peripher Nerve Inj

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Traumatic extradural arachnoid cyst is a rare entity. However, late appearance of paraparesis due to formation of an extradural arachnoid cyst as a sequel of brachial plexus injury is extremely rare and the literature regarding this issue is scarce revealing only 11 cases. Herein, we report a patient with delayed progressive spastic paraparesis appearing after a multilevel brachial plexus root avulsion injury where imaging revealed formation of a large traumatic extradural arachnoid cyst at the cervicothoracic region. Furthermore, to propose that a high-energy trauma might simultaneously result in delayed formation of an extradural arachnoid cyst. However, preganglionic root avulsion injury with pseudomeningocele formation in association with extradural arachnoid cyst is not reported previously. A case of a 36-year-old man with spastic paraparesis developing 2 years after a multilevel brachial plexus root avulsion injury is presented. Root avulsion had immediately resulted in complete paralysis of the left upper limb that had not ameliorated. Imaging studies of the cervicothoracic region disclosed left-sided multilevel pseudomeningoceles and a large extradural arachnoid cyst extending from C5 to T2. After appropriate en bloc laminotomy, the cyst was excised and the causative dural tear was closed. Subsequently, three large defects of pseudomeningoceles were obliterated with artificial dural patch for the prevention of cord herniation. This was followed with laminoplasty of the corresponding levels after dural closure. The postoperative course was uneventful and paraparesis recovered steadily within 2 months. Paraparesis even years after brachial plexus injury should be regarded as a serious event that deserves extensive imaging survey for the possibility of the formation of an extradural arachnoid cyst. Careful review of the literature disclosed that the current case is the 12th case that an extradural arachnoid cyst has developed after brachial plexus injury and the first example that the pathogenic factor that might be implicated in occurrence of this rare association could be clarified with review of the MRI features. Actually, the presence of posttraumatic pseudomeningoceles in association with an arachnoid cyst in the current case is in favor of the belief that only preganglionic root injuries that are in close proximity to the spinal canal had been the cause dural tear with remote formation of extradural arachnoid cyst.

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Thoracolumbar Epidural Arachnoid Cyst of Difficult Clinical Management: Case Report

et al. 2018

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Introduction: Among the primary lesions occupying the spinal space, only 1% corresponds to the epidural arachnoid cyst (EAC). This condition is usually asymptomatic, and identified accidentally in imaging tests. In symptomatic cases, total surgical resection is recommended. Objective: To describe a case of EAC refractory to clinical treatment. Methods: A 45-year-old woman had lumbar pain for six years and increased pain in the last months, with irradiation to the left lower limb (corresponding to L1). No other alterations found in the physical examination. Magnetic resonance imaging (MRI) of the spine revealed an intravertebral cystic lesion at T12-L1 level, in the left posterolateral position, causing enlargement of the foramen, and suggesting an epidural arachnoid cyst. Results: Due to failure of the initial clinical treatment, the patient underwent left T12-L1 hemilaminectomy, resection of the cyst and correction of dural failure. The patient progressed with effective pain control and MRI confirmed absence of residual lesion. Conclusion: EAC is more common in men (4:1) and may be congenital or acquired. The most common topography is thoracic (65%). Its clinical presentation is low back pain, lower limb pain and paresthesia. MRI is the method of choice for diagnosis and surgical intervention is restricted to cases that are symptomatic or refractory to clinical treatment, and the prognosis tends to be excellent. We conclude that, in addition to being a rare and commonly asymptomatic condition, an adequate therapeutic approach is essential for complete cure, avoiding intense pain and manifestations that bring about a drastic reduction of functional capacity. Level of evidence: IV. Type of study: Case series.

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Spinal extradural arachnoid cysts

Cited by 4 publications

References 51 publications

Brachial Plexus Root Avulsion Injury with Occipital Condyle Fractures. Case Study

Brachial Plexus Root Avulsion Injury with Occipital Condyle Fractures. Case Study

Remote Paraparesis due to a Traumatic Extradural Arachnoid Cyst Developing 2 Years after Brachial Plexus Root Avulsion Injury: Case Report and Review of the Literature

Thoracolumbar Epidural Arachnoid Cyst of Difficult Clinical Management: Case Report

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