Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
Neurosurgery. 2012 Feb;70(2):320-8; discussion 328. doi: 10.1227/NEU.0b013e318230968c.
Ventral spinal epidural meningeal cysts are rare entities for which the pathogenesis is poorly understood.
We present the clinical, radiographic, surgical, and pathologic findings of 4 patients with extensive ventral spinal epidural meningeal cysts and review the relevant literature. In addition, we discuss a suspected mechanism for pathogenesis.
Four patients with anterior spinal epidural meningeal cysts are retrospectively reviewed.
Ventral spinal epidural meningeal cysts are often large, extending on average from C2 to L1 in our series. Patients typically present with a prolonged course of symptoms and signs, including segmental muscle weakness and atrophy, subtle myelopathy, mild to moderate spinal pain, and headache. Histopathologic analysis of the cyst wall demonstrates collagenous tissue consistent with dura but without arachnoid features. Dynamic computed tomographic myelography is the study of choice for localization of the primary dural defect. Patient symptoms and neurological deficits routinely improve after appropriate surgical intervention.
Diverse signs and symptoms herald the presentation of ventral spinal meningoceles. Intraoperative, radiographic, and pathological findings are all suggestive of an intradural dissection as the etiology. Hence, they may be more appropriately named "ventral spinal intradural dissecting meningoceles." Definitive treatment involves identification and obliteration of the dural defect.
脊髓腹侧硬脊膜外脑脊膜囊肿是一种罕见的疾病，其发病机制尚不清楚。
我们报告了 4 例广泛脊髓腹侧硬脊膜外脑脊膜囊肿患者的临床、影像学、手术和病理发现，并复习了相关文献。此外，我们还讨论了一种可能的发病机制。
回顾性分析 4 例前脊髓硬脊膜外脑脊膜囊肿患者。
脊髓腹侧硬脊膜外脑脊膜囊肿通常较大，在我们的系列中平均从 C2 延伸到 L1。患者通常表现为长期的症状和体征，包括节段性肌肉无力和萎缩、轻微的脊髓病、轻度至中度的脊髓痛和头痛。囊肿壁的组织病理学分析显示为与硬脑膜一致的胶原组织，但没有蛛网膜特征。动态 CT 脊髓造影是定位原发性硬脑膜缺陷的首选研究方法。适当的手术干预后，患者的症状和神经功能缺损通常会改善。
不同的症状和体征预示着脊髓腹侧脑脊膜膨出的发生。术中、影像学和病理学表现均提示硬脊膜内分离为病因。因此，它们可能更恰当地命名为“脊髓腹侧硬脊膜内分离性脑脊膜囊肿”。明确的治疗方法包括识别和消除硬脑膜缺陷。
