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Acta Neurochirurgica

, Volume 152, Issue 7, pp 1245–1249 | Cite as

Pulsatile wall movement of spinal arachnoid cyst deteriorates spinal cord symptoms: report of three cases

  • Takeo BabaEmail author
  • Izumi Koyanagi
  • Kazuhisa Yoshifuji
  • Tomohiro Murakami
  • Kiyohiro Houkin
Case Report

Abstract

Introduction

Symptomatic spinal arachnoid cyst is a rare disease and the pathophysiology causing spinal cord symptoms has not been well clarified.

Patients and methods

The authors report three symptomatic cases of spinal arachnoid cyst at the thoracic level. These patients, aged from 70 to 73 years, showed progressive gait disturbance for a few months before admission. Phase-contrast cine magnetic resonance imaging demonstrated significant compression at the rostral side of the cyst during the diastolic phase of the cardiac cycle. Intraoperative ultrasonography demonstrated that the maximum expansion of the cyst and compression of the dorsal spinal cord occurred when the cerebrospinal fluid moved rostrally during diastole. All patients showed good improvement of their symptoms after surgical removal of the arachnoid cyst.

Conclusion

This report proposes the pathophysiology that the pulsatile enlargement of the arachnoid cyst during diastolic cardiac phase can be an important factor for deterioration of spinal cord symptoms.

Keywords

Cardiac cycle Cerebrospinal fluid Cine magnetic resonance imaging Spinal arachnoid cyst Ultrasonography 

Supplementary material

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Movie 2

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Takeo Baba
    • 1
    Email author
  • Izumi Koyanagi
    • 2
  • Kazuhisa Yoshifuji
    • 3
  • Tomohiro Murakami
    • 2
  • Kiyohiro Houkin
    • 2
  1. 1.Department of NeurosurgeryShinsapporo Neurosurgical HospitalSapporoJapan
  2. 2.Department of NeurosurgerySapporo Medical University, School of MedicineSapporoJapan
  3. 3.Department of NeurosurgeryHokkaido Medical Center for Child Health and RehabilitationSapporoJapan

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