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Published on: July 21, 2023
A Case of Miyazaki Syndrome Caused by Arachnoid Cyst-Peritoneal Shunt
Tomonori Ichikawa1, Ryuta Yasuda1, Masayuki Maeda2
1Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Japan.
Background:
Miyazaki syndrome is overshunting-associated myelopathy, which is a rare complication of ventriculoperitoneal shunt. We present the first case of Miyazaki syndrome caused by cystoperitoneal (CP) shunt for an arachnoid cyst (AC) in this report.
Case Description:
We report a case of a 42-year-old man with 12-year progressive spastic paraplegia, who underwent CP shunt for an AC at the age of 15 years. Although few findings suggested overshunting on symptoms and head computed tomography, contrast-enhanced magnetic resonance imaging revealed the engorgement of the cervical spinal epidural venous plexus compressing the spinal cord. Shunt valve replacement with a pressure-adjustable valve was performed. Postoperatively, the cervical cord compression by the enlarged spinal epidural venous plexus was completely improved, but, possibly due to delayed diagnosis and treatment, the patient's symptoms only partially improved.
Conclusions:
When patients with a history of any kind of shunt surgery develop myelopathy, Miyazaki syndrome should be suspected and, for early diagnosis, cervical and/or contrast-enhanced magnetic resonance imaging should be performed.
Insights
Miyazaki syndrome, a rare myelopathy linked to shunts, was diagnosed in a patient with a cystoperitoneal shunt. Early MRI is crucial for diagnosing this overshunting complication.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Miyazaki syndrome is a rare myelopathy associated with cerebrospinal fluid (CSF) shunts.
- It is typically linked to ventriculoperitoneal shunts but can occur with other CSF diversionary devices.
- This report details the first known case of Miyazaki syndrome resulting from a cystoperitoneal shunt used for an arachnoid cyst.
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