Spinal intramedullary ependymal cyst and tethered cord in an adult

Takçı, Erhan; Sengul, Goksin; Keleş, Muzaffer Oğuz

doi:10.3171/spi.2006.4.6.506

Cited by 15 publications

(19 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All of these cysts are infrequent, but spinal intramedullary ependymal cysts are particularly rare. Only 17 pathologically proven cases have been reported since the first was published in 19381,5,6,10,14,16). Here, we report an additional case: a 46-year-old female with an intramedullary ependymal cyst in the conus medullaris.…”

Section: Introductionmentioning

confidence: 83%

“…The most widely accepted hypothesis regarding the genesis of ependymal cysts holds that the floor plate of the neural tube is evaginated on the ventral side and becomes isolated to form an ependymal cyst5,14,16). The locations of the isolated ependymal cells determine whether the cyst presentation is intramedullary or extramedullary5).…”

Section: Discussionmentioning

confidence: 99%

“…The surgical approaches to spinal intramedullary ependymal cysts include fenestration and resection of the cyst wall, placement of cyst-to-pleural space and cyst-to-subarachnoid space shunts, and biopsies of the cyst wall1,5,6,10,11,14,16). The aim of surgical treatment should be neural decompression and prevention of the cyst from refilling, which is best accomplished by completely resecting the cyst and closing the communication between the cyst and the subarachnoid space6,16).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Spinal Intramedullary Ependymal Cysts : A Case Report and Review of the Literature

Park

Hyun

Kim

et al. 2012

J Korean Neurosurg Soc

View full text Add to dashboard Cite

We report a rare case of a spinal intramedullary ependymal cyst in a 46-year-old female and review the 17 pathologically proven cases in the literature. The patient presented with a two-week history of gradually increasing tingling in her left posterior thigh and calf. A preoperative magnetic resonance image revealed a well-defined intramedullary cystic lesion on the ventral side of the spinal cord at the T11 to T12 levels. The lesion was hyper intense in T2-weighted images and hypointense in T1-weighted. The patient underwent a right-side hemilaminectomy at the T11 to T12 levels and fenestration of the cyst wall. After having the cyst wall partially removed and communication established between the cyst and the subarachnoid space, the patient improved neurologically. A histological study of the surgical specimens revealed that the cyst wall consisted of glial cells lined by a simple cuboidal to columnar epithelium. An immunohistochemical examination of the cells lining the cyst wall was positive for S-100 protein, glial fibrillary acidic protein, epithelial membrane antigen, and cytokeratin. We suggest that the optimal treatment of intramedullary ependymal cysts creates adequate communication between the cyst and the subarachnoid space.

show abstract

Section: Introductionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Spinal Intramedullary Ependymal Cysts : A Case Report and Review of the Literature

Park

Hyun

Kim

et al. 2012

J Korean Neurosurg Soc

View full text Add to dashboard Cite

show abstract

“…19,24 Both are ventrally situated, non-contrast enhancing cystic lesions that are hypointense on T1-WI and hyperintense on T2-WI. 8–10,12–22,24 Thus, pathologic analysis is paramount for accurate diagnosis. Ependymal cysts are characterized by a thin glial layer lined by simple/pseudostratified columnar or cuboidal epithelium lacking a basement membrane.…”

Section: Discussionmentioning

confidence: 99%

Discovery of Aquaporin-1 and Aquaporin-4 Expression in an Intramedullary Spinal Cord Ependymal Cyst: Case Report

et al. 2017

View full text Add to dashboard Cite

Background Intramedullary ependymal cysts of the spinal cord are rare, benign fluid filled cysts usually situated along the ventral surface of the spinal cord. Since they were first described, only 32 cases have been reported. Thus, owing to the rarity at which these cysts are encountered, their management and pathogenesis remain controversial. While some have previously advocated for cysto-subarachnoid shunt placement for symptomatic ependymal cysts, others have argued for complete cyst resection or simple fenestration. Herein we report the case of a 56-year-old female with a T11-T12 ependymal cyst that was successfully managed with cyst fenestration. We further investigated a potential pathologic mechanism of cyst formation by performing immunohistochemistry to detect aquaporin expression in the cyst lining. Case Description A 56-year-old female was found to harbor an enlarging cystic lesion of the conus which was discovered upon workup of progressive paraparesis and urinary incontinence. She had lower extremity weakness and progressive myelopathy. Thoracic laminectomy with cyst fenestration was performed, arresting her neurologic deterioration. Pathologic analysis diagnosed an intramedullary ependymal cyst. Immunohistochemistry was subsequently performed for expression of aquaporin-1 and aquaporin-4. There was dense staining of the underlying neuropil with concurrent membranous staining pattern of the cyst lining. Conclusion Intramedullary ependymal cysts are rare, cystic lesions of the spinal cord. Early cyst fenestration decompresses the cyst and prevents neurologic deterioration. We identified for the first time that aquaporins are expressed in the cyst wall which is consistent with a passive, osmotic pathogenic mechanism of cyst formation.

show abstract

“…6 The cysts do not communicate with the central canal. 16 The term "ventriculus terminalis," or fifth ventricle, refers to an ependyma-lined space of the conus medullaris containing CSF. This ventricle is formed during embryogenesis as a result of canalization and retrogressive differentiation.…”

Section: Discussionmentioning

confidence: 99%

Spinal intradural cystic venous angioma originating from a nerve root in the cauda equina

Nishimura

Hara

Natsume

et al. 2013

SPI

View full text Add to dashboard Cite

V ascular lesions comprise approximately 6%-7% of all spinal intradural tumors. 12 Spinal vascular malformations may be classified as capillary telangiectasias, cavernous angiomas, arteriovenous malformations, or venous angiomas. 9 Venous angiomas are the most frequently encountered cerebral vascular malformations, with an incidence of up to 2.6% in a series of 4069 brain autopsies.14 However, spinal venous angiomas are extremely rare lesions. Only 2 previous reports of spinal epidural venous angiomas 3,9 have been found, but a previous report on spinal intradural venous angiomas was not encountered.We present an extremely rare spinal, intradural, extramedullary cystic venous angioma originating from a spinal nerve root in the cauda equina, which appears to be the first recorded example with a detailed assessment using MRI, intraoperative photography, and immunohistochemistry. Case ReportHistory and Examination. A 54-year-old woman had a 4-year-history of low-back pain. This was followed by the development of left-sided pain in the hip, thigh, and inguinal and perianal regions, with progressive worsening during the 2 weeks prior to admission. On examination, the patient had severe left-sided pain and numbness in the hip, thigh, and inguinal and perianal regions, but no muscular weakness. She also had normal rectal tone and bladder function. Laboratory analysis revealed no abnormalities.A lumbar spine MR image revealed a cystic mass at Division of Neurosurgery, St. Michael's Hospital, University of Toronto, Ontario, CanadaA spinal intradural extramedullary venous angioma is extremely rare and has not been previously reported. In this paper, the authors report on this entity with morphological and immunohistochemical evidence, and discuss the surgical strategy for its treatment. A 54-year-old woman presented to Nagoya University Hospital complaining of left-sided pain in the hip, thigh, and inguinal and perianal regions, with progressive worsening during the previous 2 weeks. Lumbar spine MRI showed an intradural extramedullary cyst at the level of T12-L1, which extended from the conus medullaris to the cauda equina. The cyst wall was not enhanced on T1-weighted MRI with Gd. Intraoperatively, a midline dural opening allowed the authors to easily visualize a dark-reddish cyst behind the spinal nerve rootlets in the cauda equina adjacent to the conus medullaris. The cyst was believed to originate from one of the spinal nerve rootlets in the cauda equina and a cluster of veins was identified on the cyst wall. The cyst was resected with the affected nerve rootlet. The surgery left no detectable neurological deficit. Based on the morphological and immunohistochemical evidence, the lesion was diagnosed as a venous angioma. No tumor recurrence was confirmed based on MRI at the time of the 2-year follow up. This is the first report of an intradural extramedullary cystic venous angioma that was successfully resected. (http://thejns.org/doi/abs/10.3171/2013.8.SPINE121012) keY WorDs • venous angioma • intradural • cysti...

show abstract

Spinal intramedullary ependymal cyst and tethered cord in an adult

Cited by 15 publications

References 11 publications

Spinal Intramedullary Ependymal Cysts : A Case Report and Review of the Literature

Spinal Intramedullary Ependymal Cysts : A Case Report and Review of the Literature

Discovery of Aquaporin-1 and Aquaporin-4 Expression in an Intramedullary Spinal Cord Ependymal Cyst: Case Report

Spinal intradural cystic venous angioma originating from a nerve root in the cauda equina

Contact Info

Product

Resources

About