Riviérez M, Vernant J C, Landau-Ossondo M, François M A
Service de Neurochirurgie, CHRU, Hôpital P. Zobda-Quitman, Fort-de-France, Martinique.
Neurochirurgie. 1993;39(5):322-5.
The authors report a case of intradural posterolateral spinal arachnoid cyst diagnosed by Magnetic Resonance Imaging (MRI) in a 59-year-old woman. Ten years before, she started to suffer from burning sensation of the left lower limb aggravated by head movements. Physical examination was normal except a sensory dissociation below T10. A myelography was considered as normal. Three years later, motor disturbances occur with progressive weakness. Examination showed asymmetrical spastic paraparesis with a right predominance. On MRI, the spinal cord was displaced at T6-T7 level by a posterior intradural mass with a similar signal than CSF; furthermore, at this level, there was an intramedullary hyposignal on T1 weighted sections. The diagnosis of spinal intradural arachnoid cyst was confirmed at surgery. Microscopic examination of the cyst wall showed fibrous tissue with mild lymphocytic infiltration. Rapid recovery of legs weakness followed, but abnormalities of spinothalamic functions persisted. The clinical characteristics and the MRI data are discussed. The authors conclude that this arachnoid cyst had an inflammatory origin.
作者报告了一例59岁女性患者,经磁共振成像(MRI)诊断为硬脊膜内后外侧脊髓蛛网膜囊肿。十年前,她开始出现左下肢烧灼感,头部活动会使其加重。体格检查除T10以下感觉分离外均正常。脊髓造影被认为正常。三年后,出现运动障碍且进行性加重。检查显示不对称性痉挛性截瘫,右侧为主。MRI显示,在T6 - T7水平,脊髓被一个硬脊膜内后方肿块推移,该肿块信号与脑脊液相似;此外,在这个水平,T1加权像上有脊髓内低信号。手术确诊为脊髓硬脊膜内蛛网膜囊肿。囊肿壁的显微镜检查显示为纤维组织伴轻度淋巴细胞浸润。随后腿部无力迅速恢复,但脊髓丘脑功能异常持续存在。文中讨论了临床特征和MRI数据。作者得出结论,该蛛网膜囊肿起源于炎症。