Paroxysmal raised intracranial pressureassociated with spinal meningeal cysts

Raised intracranialpressure in association with spinalmeningeal cysts has rarely been reported.We describe four patientsin whom evidence of paroxysmalraised intracranial pressure wasfound in association with spinalmeningeal cysts. Cerebrospinalfluid diversion procedures havepreviously been shown to relievelocal symptoms due to spinal cysts.In our patients symptoms ofparoxysmal headache were alleviatedby this method, suggesting acausal relationship with the raisedpressure. This association may bean under diagnosed cause ofparoxysmal headaches. We reviewthe medical literature on the classificationof spinal meningeal cysts,evaluate the theories of their originand offer suggestions on the pathogenesisof the abnormal CSF dynamicsthat may allow an interplaybetween raised intracranial pressureand spinal meningeal cysts toproduce paroxysmal symptoms.