Arachnoiditis ossificans with arachnoid cyst after cranial tuberculous meningitis

A 34-year-old woman developed symptomatic arachnoiditis ossificans and an arachnoid cyst as a consequence of tuberculous meningitis adequately treated 20 years before. Surgical decompression of the cyst stopped the progression of her spastic paraparesis. Pathologic examination confirmed the presence of ossification of the arachnoid.     

Arachnoiditis ossificans and syringomyelia: a unique case report.

A 62-year-old male presented with progressive quadriparesis. Magnetic resonance imaging of the spine revealed a spinal cord syrinx but failed to detect extensive arachnoiditis ossificans noted on insertion of a syringopleural shunt. A postoperative computed tomography scan clearly demonstrated the abnormality and its extent. We present a rare case of syringomyelia resulting from spinal arachnoiditis ossificans and review the relevant literature.     

Retrocerebellar arachnoid cyst with syringomyelia: a case report

Association of syringomyelia with retrocerebellar arachnoid cysts is rare. A case of 14 year old female is being reported, who presented with hydrocephalus caused by a large midline retrocerebellar infravermal arachnoid cyst leading to obstruction of the outlet foramina of the fourth ventricle. There was associated syringomyelia. The pathogenesis of syringomyelia is discussed. The need to evaluate cervical spinal cord by taking T1 weighted sagittal sections in all the patients of large posterior fossa mass lesions causing obstruction to the outlet foramina of the fourth ventricle has been stressed, in order to detect associated syringomyelia.     

Anterior cervical arachnoid cyst simulating syringomyelia: a case with preceding posterior arachnoid cysts.

An arachnoid cyst lying anterior to the cervical cord at level C6-7 was found in a 28-year-old woman believed to have syringomyelia. This diagnosis was based both on previous findings at laminectomy and on computerized tomography. The diagnosis of arachnoid cyst was suspected because of clinical features atypical for classical syringomyelia and a history of arachnoid cysts found during childhood. Air myelography demonstrated an extramedullary intradural mass anteriorly that proved to be an arachnoid cyst. Drainage and subtotal resection resulted in marked clinical improvement. This case illustrates the need for reevaluation when a patient with "known" syringomyelia presents an atypical clinical picture. Anterior cervical arachnoid cyst, which may accompany or succeed posterior arachnoid cysts, should be considered.     

Extended extradural spinal arachnoid cyst: an unusual cause of progressive spastic paraparesis

A 15-year old girl presented with a slowly progressive spastic paraparesis since the age of 12. Creatine kinase was slighty increased. Muscle biopsy carried out during tendon surgery for severe toe-walking showed ‘myopathic’ changes. Subsequent neurological evaluation and radiological studies revealed a large extradural arachnoid cyst extending from the 11th thoracic vertebra to the first lumbar vertebra. Her condition improved after operation. The ‘myopathic’ features turned out to be the result of chronic spinal compression. MRI is the method of choice to examine patients with non-hereditary progressive spastic paraparesis. Muscle biopsy and tendon surgery should not be performed, without careful neurological examination.     

Symptomatic sacral extradural arachnoid cyst associated with lumbar intradural arachnoid cyst.

A case of sacral extradural arachnoid cyst associated with lumbar intradural arachnoid cyst in a 35-year-old male is reported. The patient presented with a history of severe sacrococcygeal pain, constipation, and dysuria for several months. Computed tomographic (CT) myelograms and magnetic resonance imaging (MRI) scans showed a huge sacral cyst without neural components. A favorable outcome could be achieved by decompression of the cyst, obliteration of the fistulous channel between the cyst and the thecal sac, and fenestration of the arachnoid cyst into the subarachnoid space. The relevant literatures are also reviewed.     

Magnetic resonance diagnosis of spinal arachnoid cyst

Magnetic resonance (MR) findings in one case each of extradural and intradural arachnoid cyst are described. Thoracic segments were involved in both cases. The cysts were slightly more intense than cerebrospinal fluid in both cases on T1 weighted images. The nature and extent of the lesions wer better demonstrated on MR images as compared with combined myelography and computed tomography.     

Symptomatic spinal arachnoid cyst in an elderly subject

We report an unusual case of idiopathic thoracic intradural arachnoid cyst causing a chronic progressive spastic paraparesis in a 72 year old man. Symptoms completely resolved after surgical excision of the cyst.

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Sommario Viene riportato il caso di un paziente di 72 anni affetto da paraparesi spastica cronica progressiva causata da una cisti aracnoidea idiopatica, intradurale a livello toracico. I sintomi sono completamente regrediti dopo rimozione chirurgica della cisti.

     

Fourth ventricle arachnoid cyst.

We report four patients with fourth ventricle arachnoid cysts. There were two males and two females and the ages ranged from 18 months to 52 years (average 21 years). All patients presented with symptoms of raised intracranial pressure. Excision or marsupialization of the arachnoid cyst in this location was curative in all patients. The follow-up ranged from 1 to 14 years.     

Hypothalamic hamartoma associated with an arachnoid cyst.

A hypothalamic hamartoma associated with an arachnoid cyst in an 8-year-old boy is reported herein. He presented with precocious puberty, and neuroimaging studies demonstrated a solid mass in the prepontine cistern and a huge arachnoid cyst in the left cranial fossa. The mass appeared isointense to the surrounding cerebral cortex on T1-weighted magnetic resonance images, hyperintense on T2-weighted images, and was not enhanced after administration of Gd-DTPA. The patient underwent a left frontotemporal craniotomy and a cyst-peritoneal shunt was inserted. Histological features of the cyst wall and the mass were characteristic of an arachnoid cyst and hamartoma, respectively. While a hypothalamic hamartoma associated with an arachnoid cyst is rare, such a case may help clarify the geneses of both anomalous lesions.     

椎管内硬脊膜外蛛网膜囊肿的临床特点及手术治疗

目的 探讨椎管内硬脊膜外蛛网膜囊肿的临床表现、手术方法及疗效。方法 2005年1月至2015年1月手术治疗椎管内硬脊膜外蛛网膜囊肿28例,其中采用囊肿全切+交通孔封闭术治疗5例,囊肿部分切除+交通孔封闭术治疗17例,囊肿切开+带蒂竖脊肌置入缝合术治疗6例。结果 术后随访5~72个月,平均51.6个月;症状完全消失18例,明显改善8例,无明显变化2例;术后复查脊椎MRI,仅1例复发。2例囊肿长度16 cm左右,术后出现较明显的脊柱后突畸形。结论 椎管内硬脊膜外蛛网膜囊肿建议采用囊肿全切+交通孔封闭术;若术中无法行囊肿全切或难以找到交通孔,则采用囊肿部分切除+交通孔封闭术或囊肿切开+带蒂竖脊肌置入缝合术,也是有效的手术方式。     

Proteus syndrome with syringohydromyelia and arachnoid cyst

Introduction Proteus syndrome (PS) is a rarely seen, sporadic disorder with a wide range of abnormalities including asymmetrical overgrowth, skin lesions, dysregulated adipose tissue, and vascular malformations. Brain and spinal malformations are extremely rare; syringohydromyelia and arachnoid cyst have not been reported previously. Materials and methods We present a 5-year-old girl with PS having severe central nervous system (CNS) abnormalities demonstrated by magnetic resonance imaging (MRI) including craniocutaneous lipomatosis, hemimegalencephaly, arachnoid cyst, and syringohydromyelia. A commentary on this paper is available at doi: .     

Proteus syndrome with syringohydromyelia and arachnoid cyst

Introduction

Proteus syndrome (PS) is a rarely seen, sporadic disorder with a wide range of abnormalities including asymmetrical overgrowth, skin lesions, dysregulated adipose tissue, and vascular malformations. Brain and spinal malformations are extremely rare; syringohydromyelia and arachnoid cyst have not been reported previously.

Materials and methods

We present a 5-year-old girl with PS having severe central nervous system (CNS) abnormalities demonstrated by magnetic resonance imaging (MRI) including craniocutaneous lipomatosis, hemimegalencephaly, arachnoid cyst, and syringohydromyelia.

     

Intracranial arachnoid cyst with subdural hematoma

A case of a middle fossa arachnoid cyst associated with a post-traumatic subdural hematoma is reported, where the inner membrane of the hematoma did not entirely cover the cyst surface. At operation a third cavity was detected between the arachnoid cyst and the hematoma and it is postulated that the subdural hematoma was consequent to the developmental anomaly. We have reviewed 72 cases in the literature and discuss the management of subdural hematoma in the presence of arachnoid cysts.