Skip to main content

Advertisement

SpringerLink
Log in

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

  • Case Report
  • Published:
Acta Neurochirurgica Aims and scope

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

References

  1. Abou-Fakhr FS, Kanaan SV, Youness FM, Hourani MH, Haddad MC (2002) Thoracic spinal intradural arachnoid cyst: report of two cases and review of the literature. Eur Radiol 12:877–882

    Article  PubMed  Google Scholar 

  2. Agnoli AL, Schonmayr R, Laun A (1982) Intraspinal arachnoid cysts. Acta Neurochir (Wien) 61:291–302

    Article  CAS  Google Scholar 

  3. Brodbelt AR, Stoodley MA (2003) Syringomyelia and the arachnoid web. Acta Neurochir 145:707–711

    Article  CAS  Google Scholar 

  4. Dietemann JL, Filippi de la Palavesa MM, Kastler B, Warter JM, Buchheit F (1991) Thoracic intradural arachnoid cyst: possible pitfalls with myelo-CT and MR. Neuroradiology 33:90–91

    Article  CAS  PubMed  Google Scholar 

  5. Doita M, Nishida K, Miura J, Takada T, Kurosaka M, Fujii M (2003) Kinematic magnetic resonance imaging of a thoracic spinal extradural arachnoid cyst: an alternative suggestion for exacerbation of symptoms during straining. Spine 28:E229–E233

    Article  PubMed  Google Scholar 

  6. Fortuna A, Mercuri S (1983) Intradural spinal cysts. Acta Neurochir (Wien) 68:289–314

    Article  CAS  Google Scholar 

  7. Fujimura M, Tominaga T, Koshu K, Shimizu H, Yoshimoto T (1996) Cine-mode magnetic resonance imaging of a thoracic intradural arachnoid cyst: case report. Surg Neurol 45:533–536

    Article  CAS  PubMed  Google Scholar 

  8. Holly LT, Batzdorf U (2006) Syringomyelia associated with intradural arachnoid cysts. J Neurosurg Spine 5:111–116

    Article  PubMed  Google Scholar 

  9. Krings T, Lukas R, Reul J, Spetzger U, Reinges MH, Gilsbach JM, Thron A (2001) Diagnostic and therapeutic management of spinal arachnoid cysts. Acta Neurochir (Wien) 143:227–235

    Article  CAS  Google Scholar 

  10. Kumar K, Malik S, Schulte PA (2003) Symptomatic spinal arachnoid cysts: report of two cases with review of the literature. Spine 28:E25–E29

    Article  PubMed  Google Scholar 

  11. Lee TT, Alameda GJ, Camilo E, Green BA (2001) Surgical treatment of post-traumatic myelopathy associated with syringomyelia. Spine 26:S119–S127

    Article  CAS  PubMed  Google Scholar 

  12. Lesoin F, Rousseau M, Thomas CE 3rd, Jomin M (1984) Post traumatic spinal arachnoid cysts. Acta Neurochir (Wien) 70:227–234

    Article  CAS  Google Scholar 

  13. Nauta HJ, Dolan E, Yasargil MG (1983) Microsurgical anatomy of spinal subarachnoid space. Surg Neurol 19:431–437

    Article  CAS  PubMed  Google Scholar 

  14. Palmer JJ (1974) Spinal arachnoid cysts. Report of six cases. J Neurosurg 41:728–735

    Article  CAS  PubMed  Google Scholar 

  15. Perret G, Green D, Keller J (1962) Diagnosis and treatment of intradural arachnoid cysts of the thoracic spine. Radiology 79:425–429

    CAS  PubMed  Google Scholar 

  16. Shimizu H, Tominaga T, Takahashi A, Yoshimoto T (1997) Cine magnetic resonance imaging of spinal intradural arachnoid cysts. Neurosurgery 41:95–100

    Article  CAS  PubMed  Google Scholar 

  17. Sklar E, Quencer RM, Green BA, Montalvo BM, Post MJ (1989) Acquired spinal subarachnoid cysts: evaluation with MR, CT myelography, and intraoperative sonography. Am J Roentgenol 153:1057–1064

    CAS  Google Scholar 

  18. Tumialán LM, Cawley CM, Barrow DL (2005) Arachnoid cyst with associated arachnoiditis developing after subarachnoid hemorrhage. Case report. J Neurosurg 103:1088–1091

    Article  PubMed  Google Scholar 

  19. Valls PL, Naul LG, Kanter SL (1990) Paraplegia after a routine lumbar laminectomy: report of a rare complication and successful management. Neurosurgery 27:638–640

    Article  CAS  PubMed  Google Scholar 

  20. Wang MY, Levi AD, Green BA (2003) Intradural spinal arachnoid cysts in adults. Surg Neurol 60:49–55

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Shinsapporo Neurosurgical Hospital, 1-2-1-10 Kaminopporo, Atsubetu-ku, Sapporo, 004-0031, Japan

    Takeo Baba

  2. Department of Neurosurgery, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, Japan

    Izumi Koyanagi, Tomohiro Murakami & Kiyohiro Houkin

  3. Department of Neurosurgery, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Hokkaido, Japan

    Kazuhisa Yoshifuji

Authors
  1. Takeo Baba
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Izumi Koyanagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kazuhisa Yoshifuji
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tomohiro Murakami
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kiyohiro Houkin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Takeo Baba.

Electronic supplementary materials

(MPG 3034 kb)

(MPG 2419 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Baba, T., Koyanagi, I., Yoshifuji, K. et al. Pulsatile wall movement of spinal arachnoid cyst deteriorates spinal cord symptoms: report of three cases. Acta Neurochir 152, 1245–1249 (2010). https://doi.org/10.1007/s00701-009-0571-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-009-0571-3

Keywords

Search

Navigation