Takano Morito, Hikata Tomohiro, Nishimura Soraya, Ishikawa Masayuki, Kamata Michihiro
1Department of Orthopaedic Surgery, Spine Center, Kitasato Institute Hospital, Tokyo, Japan.
2Department of Orthopaedic Surgery, Kawasaki Municipal Hospital, Kanagawa, Japan.
J Neurosurg Case Lessons. 2023 Jan 2;5(1). doi: 10.3171/CASE22464.
Spinal extradural arachnoid cysts are thought to be pouches that communicate with the intraspinal subarachnoid space through a dural defect. The treatment for these cysts is resection of the cyst wall followed by obliteration of the communicating defect, which is often elusive.
The authors report the case of a 22-year-old man with an extradural arachnoid cyst with claudication and progressive motor weakness. Regular magnetic resonance imaging (MRI) and computed tomography did not reveal the location of the defect in the cyst. However, three-dimensional (3D) phase-contrast MRI clearly indicated the location of the defect and the flow of cerebrospinal fluid into the cyst. These findings allowed the authors to perform the least invasive surgery; the patient recovered motor function and could walk more smoothly.
3D phase-contrast MRI can reveal a subtle dural defect in patients with spinal extradural arachnoid cysts.
脊髓硬膜外蛛网膜囊肿被认为是通过硬脑膜缺损与椎管内蛛网膜下腔相通的囊袋。这些囊肿的治疗方法是切除囊肿壁，然后封闭相通的缺损，但这往往难以实现。
作者报告了一例22岁男性患者，患有硬膜外蛛网膜囊肿，伴有间歇性跛行和进行性运动无力。常规磁共振成像（MRI）和计算机断层扫描未显示囊肿缺损的位置。然而，三维（3D）相位对比MRI清楚地显示了缺损的位置以及脑脊液流入囊肿的情况。这些发现使作者能够进行创伤最小的手术；患者恢复了运动功能，行走也更加平稳。
3D相位对比MRI可以揭示脊髓硬膜外蛛网膜囊肿患者细微的硬脑膜缺损。
