Utility of preoperative magnetic resonance imaging myelography for identifying dural defects in patients with spinal extradural arachnoid cysts: case report.
OBJECTIVE
Preoperative magnetic resonance imaging (MRI) myelography scans demonstrated a dural defect in a 50-year-old man with an epidural arachnoid cyst who had a 29-year history of untreated weakness and numbness both lower limbs.


METHODS
MRI scans showed a dorsal intraspinal extradural cystic lesion at the level from Th11 to L1. Although preoperative cine-MRI scans failed to display the dural defect, an MRI myelography scan showed cerebrospinal fluid in the subarachnoid space containing a cyst.


RESULTS
The site of shunting between the subarachnoid space and the cyst was visualized as a pulsating flow void to the right of Th12. We removed the cyst wall and closed the dural defect via laminectomy.


CONCLUSIONS
Because the preoperative MRI myelography scan correctly identified the existence and location of the dural defect, we conclude that MRI myelography is helpful for detecting dural defects in patients with epidural arachnoid cysts.
Miyamoto
Michiyuki
M
Department of Neurosurgery, Kushiro Rosai Hospital, Kushiro, Japan. miyamich@med.hokudai.ac.jp
Kim
Kyongsong
K
Matsumoto
Ryoji
R
Isobe
Masanori
M
Isu
Toyohiko
T
D016080:Arachnoid Cysts / Q000175:diagnosis* / Q000601:surgery*; D004388:Dura Mater / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D007796:Laminectomy; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009192:Myelography; D011300:Preoperative Care; D013116:Spinal Cord / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000601:surgery*; D013904:Thoracic Vertebrae; D014057:Tomography, X-Ray Computed