Isu T, Iizuka T, Iwasaki Y, Nagashima M, Akino M, Abe H
Department of Neurosurgery, University of Hokkaido School of Medicine, Sapporo, Japan.
Neurosurgery. 1991 Jul;29(1):137-9. doi: 10.1097/00006123-199107000-00027.
Two rare cases of spinal cord herniation associated with intradural spinal arachnoid cyst are reported. A preoperative magnetic resonance imaging scan demonstrated the presence of spinal cord herniation, identified as a protrusion continuous with the spinal cord. Surgery upon the intradural spinal arachnoid cyst improved progressive neurological dysfunction. The authors postulate that spinal cord herniation occurred for the following reason: The pressure of the intradural arachnoid cyst on the dorsal aspect of the spinal cord caused thinning of the dura, leading to a tear and, thus, the development of an extradural arachnoid cyst. Along with the enlargement of intradural arachnoid cyst, the spinal cord herniated through the tear in the dura into the extradural arachnoid cyst.
报告了两例与硬脊膜内脊髓蛛网膜囊肿相关的脊髓疝罕见病例。术前磁共振成像扫描显示存在脊髓疝,表现为与脊髓连续的突出物。对硬脊膜内脊髓蛛网膜囊肿进行手术改善了进行性神经功能障碍。作者推测脊髓疝的发生原因如下:硬脊膜内蛛网膜囊肿对脊髓背侧的压力导致硬脊膜变薄,进而撕裂,从而形成硬脊膜外蛛网膜囊肿。随着硬脊膜内蛛网膜囊肿的增大,脊髓通过硬脊膜的撕裂处疝入硬脊膜外蛛网膜囊肿。