title: Ventral extradural spinal meningeal cyst causing cord compression: neurosurgical treatment.
abstract: Spinal extradural meningeal cysts are typically formed by a thin fibrotic membranous capsule, macroscopically similar that of an arachnoid membrane, filled by cerebro spinal fluid and related to a nerve root or to the posterior midline. Ventral location is extremely rare and when it occurs they usually cause spinal cord herniation through the ventral dural gap. A 61 year-old man who began with a two years long history of insidious tetraparesis, spasticity and hyperreflexia in lower extremities, and flaccid atrophy of upper limbs, without sensory manifestations, is presented. Investigation through magnetic resonance imaging demonstrated an extensive spinal ventral extradural cystic collection from C6 to T11. The lesion was approached through a laminectomy and a cyst-peritoneal shunt was introduced. The cyst reduced in size significantly and the patient is asymptomatic over a 48 months follow-up. This is the first reported case of a spontaneous ventral extradural spinal meningeal cyst causing cord compression. Cyst-peritoneal shunt was effective in the treatment of the case and it should be considered in cases in which complete resection of the cyst is made more difficult or risky by the need of more aggressive surgical maneuvers.
authors.affiliation: Department of Neurosurgery-Hospital Nossa Senhora das Graças Curitiba PR, Brazil.
authors.forename: Daniel Monte-Serrat
authors.initials: DM
authors.lastname: Prevedello
authors.forename: Cláudio Esteves
authors.initials: CE
authors.lastname: Tatsui
authors.forename: Andrei
authors.initials: A
authors.lastname: Koerbel
authors.forename: César Vinícius
authors.initials: CV
authors.lastname: Grande
authors.forename: Joacir Graciolli
authors.initials: JG
authors.lastname: Cordeiro
authors.forename: João Cândido
authors.initials: JC
authors.lastname: Araújo
mesh_terms: D016080:Arachnoid Cysts / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009192:Myelography; D010529:Peritoneal Cavity / Q000473:pathology; D013117:Spinal Cord Compression / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D013118:Spinal Cord Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000473:pathology*; D016896:Treatment Outcome