de Oliveira Ricardo Santos, Amato Marcelo Campos Moraes, Santos Marcelo Volpon, Simão Gustavo Novelino, Machado Helio Rubens
Division of Pediatric Neurosurgery, Ribeirão Preto School of Medicine, University of São Paulo, Campus Universitário, Ribeirão Preto, São Paulo 14049-900, Brazil.
Childs Nerv Syst. 2007 Nov;23(11):1233-8. doi: 10.1007/s00381-007-0414-6. Epub 2007 Jul 13.
Extradural arachnoid cysts in the spine are uncommon causes of spinal cord compression in the pediatric population that are thought to arise from congenital defects in the dura mater. Most reports describe such cysts as communicating with the intrathecal subarachnoid space through a small defect in the dura. Excision of the cyst with obliteration of the communicating dural defect is the mainstay of treatment in symptomatic patients. Solitary extradural arachnoid cysts have been reported in several studies, but multiple extradural arachnoid cysts are very rarely reported in children.
The authors report a case of multiple extradural spinal arachnoid cysts in a 14-year-old boy who presented progressive lower extremity weakness, myelopathy, and severe gait ataxia. Magnetic resonance (MR) of the spine demonstrated four extradural arachnoid cysts extending from T-1 to T-9. The patient underwent a thoracic laminoplasty for en bloc resection of the spinal extradural arachnoid cysts. Postoperatively, the patient's motor strength and ambulation improved immediately.
Multiple spinal extradural arachnoid cysts are rarely reported in the literature. Excision of the cysts at the spinal cord level leads to a favorable outcome.
脊柱硬膜外蛛网膜囊肿是小儿脊髓受压的罕见原因，被认为起源于硬脑膜的先天性缺陷。大多数报告将此类囊肿描述为通过硬脑膜上的一个小缺陷与鞘内蛛网膜下腔相通。对于有症状的患者，切除囊肿并封闭相通的硬脑膜缺损是主要的治疗方法。多项研究报告过孤立性硬膜外蛛网膜囊肿，但儿童多发性硬膜外蛛网膜囊肿的报道非常罕见。
作者报告一例14岁男孩患有多发性脊柱硬膜外蛛网膜囊肿，该男孩出现进行性下肢无力、脊髓病和严重步态共济失调。脊柱磁共振成像（MR）显示四个硬膜外蛛网膜囊肿，从T-1延伸至T-9。患者接受了胸椎椎板成形术以整块切除脊柱硬膜外蛛网膜囊肿。术后，患者的肌力和行走能力立即得到改善。
多发性脊柱硬膜外蛛网膜囊肿在文献中报道很少。在脊髓水平切除囊肿可带来良好的预后。
