title: Paroxysmal raised intracranial pressure associated with spinal meningeal cysts.
abstract: Raised intracranial pressure in association with spinal meningeal cysts has rarely been reported. We describe four patients in whom evidence of paroxysmal raised intracranial pressure was found in association with spinal meningeal cysts. Cerebrospinal fluid diversion procedures have previously been shown to relieve local symptoms due to spinal cysts. In our patients symptoms of paroxysmal headache were alleviated by this method, suggesting a causal relationship with the raised pressure. This association may be an under diagnosed cause of paroxysmal headaches. We review the medical literature on the classification of spinal meningeal cysts, evaluate the theories of their origin and offer suggestions on the pathogenesis of the abnormal CSF dynamics that may allow an interplay between raised intracranial pressure and spinal meningeal cysts to produce paroxysmal symptoms.
authors.affiliation: The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.
authors.forename: P N
authors.initials: PN
authors.lastname: Shams
authors.forename: P J
authors.initials: PJ
authors.lastname: Goadsby
authors.forename: H A
authors.initials: HA
authors.lastname: Crockard
authors.forename: A T H
authors.initials: AT
authors.lastname: Casey
authors.forename: G T
authors.initials: GT
authors.lastname: Plant
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003560:Cysts / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000503:physiopathology*; D008875:Middle Aged; D009192:Myelography / Q000379:methods; D013118:Spinal Cord Diseases / Q000473:pathology / Q000503:physiopathology*