Huge multiple spinal extradural meningeal cysts in infancy

• Published in: Child's nervous system Vol. 35; no. 3; pp. 535 - 540
• Main Authors: Tsuchimochi, Kohei, Morioka, Takato, Murakami, Nobuya, Yamashita, Fumiya, Kawamura, Nobuko
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2019
• Subjects: Case Report; Central Nervous System Cysts - congenital; Central Nervous System Cysts - pathology; Central Nervous System Cysts - surgery; Humans; Infant; Male; Medicine; Medicine & Public Health; Meninges - pathology; Meninges - surgery; Neurosciences; Neurosurgery; Spinal Cord - pathology; Spinal Cord - surgery; Spinal Cord Diseases - congenital; Spinal Cord Diseases - pathology; Spinal Cord Diseases - surgery; Spinal meningeal cyst; Cyst removal; Extradural arachnoid cyst; Multiple cystic lesion
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-018-4009-1

Background Multiple spinal extradural meningeal cysts (SEMCs) are rare lesions. SEMCs communicate with the subarachnoid space through multiple dural defects and expand into the extradural space with progressive spinal cord compression. Case presentation We report a 5-month-old boy with hydronephrosis involving nine huge SEMCs that were distributed from the T1–L5 levels. Eight SEMCs, except for one small noncommunicating cyst, were exposed through laminoplastic laminotomy at the T10–L5 and T3–5 levels. Five transdural communications with dural defects were packed with a piece of autologous muscle and fibrin glue. Tenting sutures to lift up the dura to the vertebral arch were added to minimize the extradural dead space. Postoperatively, cord compression was relieved and hydronephrosis improved. Conclusion In conclusion, packing of all dural defects and dural tenting sutures at a one-staged operation is useful in the surgical management of huge and multiple SEMCs in infancy.