title: Clinical characteristics and surgical outcomes of spinal intramedullary ependymal cysts.
abstract: OBJECTIVE
  Intramedullary ependymal cysts are exceedingly rare lesions, and have been previously reported in the literature as case reports. The aim of this study was to discuss the clinical presentation and the outcomes of microsurgery for these benign lesions.
  
  
  METHODS
  The authors retrospectively reviewed the records of ten patients who underwent microsurgery for intramedullary ependymal cysts. All patients had preoperative and postoperative magnetic resonance imaging. The surgical treatment included gross total resection and biopsy plus a cyst-subarachnoid shunt. The diagnosis of intramedullary ependymal cysts was based on radiological and pathological criteria. All patients were followed up, with a mean duration of 47.6 months.
  
  
  RESULTS
  Intramedullary ependymal cysts were hypointense on T1-weighted images and hyperintense on T2-weighted images. Contrast-enhanced T1-weighted images showed no enhancement. Gross total resection was achieved in one case. Biopsy of the cyst wall plus cyst-subarachnoid shunt placement was achieved in nine cases. Long-term neurological function was improved in eight patients. No recurrence was observed on magnetic resonance imaging.
  
  
  CONCLUSIONS
  Ependymal cysts should be considered in the differential diagnosis of intramedullary cysts. For symptomatic patients, early surgery should be performed before neurological deficits deteriorate. Complete decompression and cyst-subarachnoid shunt placement is the optimal treatment and the outcome may be favorable.
authors: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No.6 Tiantan Xili, Dongcheng District, Beijing, 100050, China, yangtaoczh@163.com.
authors: Tao
authors: T
authors: Yang
authors: Liang
authors: L
authors: Wu
authors: Xiaofeng
authors: X
authors: Deng
authors: Chenlong
authors: C
authors: Yang
authors: Jingyi
authors: J
authors: Fang
authors: Lei
authors: L
authors: Zhao
authors: Guihuai
authors: G
authors: Wang
authors: Jun
authors: J
authors: Yang
authors: Yulun
authors: Y
authors: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D020863:Central Nervous System Cysts / Q000175:diagnosis / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D013116:Spinal Cord / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult