Syringomyelia associated with intradural arachnoid cysts
Langston T Holly1, Ulrich Batzdorf
1Division of Neurosurgery, David Geffen School of Medicine, University of California at Los Angeles, California 90095, USA.
Journal of Neurosurgery. Spine
|August 24, 2006
Summary
Intradural arachnoid cysts associated with spinal syringomyelia can cause significant neurological deficits. Surgical resection of these cysts and restoration of cerebrospinal fluid (CSF) flow led to neurological improvement and reduced syrinx size in eight patients.
Area of Science:
- Neurosurgery
- Neurology
- Spinal Surgery
Background:
- Intradural arachnoid cysts are rare cerebrospinal fluid (CSF) pouches within the subarachnoid space.
- Syringomyelia, characterized by syrinx cavities, can be associated with these cysts.
- Altered CSF dynamics are the suspected cause of this association.
Purpose of the Study:
- To present a series of symptomatic patients with spinal arachnoid cysts and associated syrinx cavities.
- To discuss treatment strategies for this specific clinical entity.
- To evaluate the outcomes of surgical intervention.
Main Methods:
- Eight male patients with symptomatic syrinx cavities and associated posterior thoracic arachnoid cysts underwent thoracic laminectomy and cyst wall resection.
- Patients had no history of spinal trauma, meningitis, or prior surgery.
- Postoperative follow-up included neurological assessment and magnetic resonance imaging.
Main Results:
- All eight patients experienced neurological improvement, primarily gait difficulty.
- Postoperative imaging showed disappearance of arachnoid cysts and significant reduction in syrinx cavity size.
- Mean follow-up was 19 months, with no evidence of enhancement, Chiari malformation, tethered cord, or hydrocephalus.
Conclusions:
- Spinal arachnoid cysts can be associated with syringomyelia due to abnormal CSF flow.
- Surgical resection of symptomatic cysts is recommended to restore normal CSF dynamics.
- This approach leads to neurological improvement and syrinx reduction in affected patients.
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