Correlation of Spinal Cord Injury With Development Of Spinal Arachnoid Cysts: Two Case Reports.

Katrien Raes, Kristine M Oostra
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Abstract

Background: Spinal arachnoid cysts are rare entities, which are composed of a duplication in the arachnoid membrane and resultant cerebrospinal fluid collection, which may present with a progressive myelopathy. The most common symptoms caused by spinal cord compression are paraesthesia, neuropathic pain, paresis and gait ataxia.

Clinical cases: We report here 2 cases from different perspectives of a spinal arachnoid cysts in spinal cord injury. The first case was the occurrence of a spinal cord injury due to compression of a spinal arachnoid cysts causing myelopathy. The second case is a patient who had a traumatic paraplegia for which stabilizing surgery was required and who subsequently developed a spinal arachnoid cysts with neuropathic pain. Both cases required surgery with immediate improvement. However, after a few months both patients needed a revision due to recurrence.

Conclusion: Spinal arachnoid cysts may present with a heterogeneous clinical picture. If cysts are not clinically apparent, a conservative treatment with careful observation can be a justifiable option. In patients with progressive symptoms, surgery is the gold standard of care. However, the literature describes the need for revision surgery in only 12.5% of cases. Regular follow-up is necessary because both of the patients reported here needed revision surgery.

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脊髓损伤与脊髓蛛网膜囊肿发展的相关性:2例报告。
背景:脊髓蛛网膜囊肿是一种罕见的实体,它由蛛网膜的重复和由此产生的脑脊液收集组成,可能表现为进行性脊髓病。脊髓压迫引起的最常见症状是感觉异常、神经性疼痛、麻痹和步态共济失调。临床病例:我们报告2例从不同角度观察脊髓损伤后的脊髓蛛网膜囊肿。第一个病例是由于脊髓蛛网膜囊肿压迫引起脊髓病而发生脊髓损伤。第二个病例为外伤性截瘫患者,需要进行稳定手术,随后出现脊髓蛛网膜囊肿并伴有神经性疼痛。两例患者均需手术治疗并立即好转。然而,几个月后,由于复发,两名患者都需要进行翻修。结论:脊髓蛛网膜囊肿可能表现出不同的临床表现。如果囊肿在临床上不明显,保守治疗和仔细观察是一个合理的选择。对于出现进行性症状的患者,手术是治疗的黄金标准。然而,文献中只有12.5%的病例需要翻修手术。定期随访是必要的,因为两位患者都需要翻修手术。
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