title: Surgical strategy for multiple huge spinal extradural meningeal cysts. Case report.
abstract: The authors describe the case of an 8-year-old boy who developed spastic paraparesis and hypalgesia below the middle thoracic level. Magnetic resonance (MR) imaging showed huge and multiple extradural cystic lesions posterior to the spinal cord from T-5 to S-1, which were associated with severe spinal cord compression, especially at the T5-8 level. Using constructive interference in steady state (CISS) MR imaging, many septa were visible that were dividing the cysts in a tandem arrangement, and the multiple cysts were distributed far laterally, extending to the root sleeves. Three transdural communications of cerebrospinal fluid into the cysts, including one that was located ventrally, were revealed by multiangled observation using CISS MR imaging and intraoperative inspection. The huge and multiple appearances of the extradural meningeal cysts on MR images suggested various stages of growth of these cysts. As this case demonstrates, cysts of this type (huge, multiple, extradural meningeal [arachnoid] cysts) need to be completely removed during one-stage surgery.
authors.affiliation: Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Samura
authors.forename: Takato
authors.initials: T
authors.lastname: Morioka
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyagi
authors.forename: Shinji
authors.initials: S
authors.lastname: Nagata
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mizoguchi
authors.forename: Futoshi
authors.initials: F
authors.lastname: Mihara
authors.forename: Tomio
authors.initials: T
authors.lastname: Sasaki
mesh_terms: D020863:Central Nervous System Cysts / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008578:Meninges / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures; D020336:Paraparesis, Spastic / Q000209:etiology; D012086:Reoperation; D012447:Sacrum; D013117:Spinal Cord Compression / Q000209:etiology; D013904:Thoracic Vertebrae; D016896:Treatment Outcome