Spinal extradural arachnoid cyst

Significance of intrathecal infusion after fistula closure

Michiari Umakoshi, Takao Yasuhara, Atsuhiko Toyoshima, Susumu Sasada, Akira Kusumegi, Jun Morimoto, Kyohei Kin, Yousuke Tomita, Isao Date

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

The spinal extradural arachnoid cyst is a rare entity. Obtaining the correct diagnosis and detecting the fistula location are critical for providing effective treatment. A 41-year-old man had numbness in the soles of his feet for 2 years with accompanying gait disturbance, and a defecation disorder. Computed tomography myelography performed at another hospital revealed an epidural arachnoid cyst from Th11 to L2. He received a subarachnoid-cyst shunt at the rostral part of the cyst. However, his symptoms worsened and he was admitted to our hospital. Neuroradiological investigations revealed the correct location of the fistula at the level of Th12. We performed partial removal of the cyst wall with fistula closure via right hemilaminectomy of Th11 and 12. The complete closure of the fistula was confirmed by intrathecal infusion of artificial cerebrospinal fluid through the shunt tube. The shunt tube was removed with the sutures. The patient's symptoms improved, although numbness remained in his bilateral heels. There has been no recurrence in 15 months since the surgery. Fistula closure may work as a balanced therapeutic strategy for spinal extradural arachnoid cyst, and intrathecal cerebrospinal fluid infusion is useful for the confirmation of complete fistula closure.

Original languageEnglish
Pages (from-to)73-76
Number of pages4
JournalActa Medica Okayama
Volume72
Issue number1
Publication statusPublished - Jan 1 2018

Fingerprint

Cerebrospinal fluid
Arachnoid Cysts
Fistula
Surgery
Tomography
Cysts
Hypesthesia
Cerebrospinal Fluid Shunts
Myelography
Defecation
Heel
Gait
Sutures
Cerebrospinal Fluid
Foot
Recurrence
Therapeutics

Keywords

  • Fistula closure
  • Intrathecal infusion
  • Microscopic surgery
  • Preoperative evaluation
  • Recurrence

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Umakoshi, M., Yasuhara, T., Toyoshima, A., Sasada, S., Kusumegi, A., Morimoto, J., ... Date, I. (2018). Spinal extradural arachnoid cyst: Significance of intrathecal infusion after fistula closure. Acta Medica Okayama, 72(1), 73-76.

Spinal extradural arachnoid cyst : Significance of intrathecal infusion after fistula closure. / Umakoshi, Michiari; Yasuhara, Takao; Toyoshima, Atsuhiko; Sasada, Susumu; Kusumegi, Akira; Morimoto, Jun; Kin, Kyohei; Tomita, Yousuke; Date, Isao.

In: Acta Medica Okayama, Vol. 72, No. 1, 01.01.2018, p. 73-76.

Research output: Contribution to journalArticle

Umakoshi, M, Yasuhara, T, Toyoshima, A, Sasada, S, Kusumegi, A, Morimoto, J, Kin, K, Tomita, Y & Date, I 2018, 'Spinal extradural arachnoid cyst: Significance of intrathecal infusion after fistula closure', Acta Medica Okayama, vol. 72, no. 1, pp. 73-76.
Umakoshi M, Yasuhara T, Toyoshima A, Sasada S, Kusumegi A, Morimoto J et al. Spinal extradural arachnoid cyst: Significance of intrathecal infusion after fistula closure. Acta Medica Okayama. 2018 Jan 1;72(1):73-76.
Umakoshi, Michiari ; Yasuhara, Takao ; Toyoshima, Atsuhiko ; Sasada, Susumu ; Kusumegi, Akira ; Morimoto, Jun ; Kin, Kyohei ; Tomita, Yousuke ; Date, Isao. / Spinal extradural arachnoid cyst : Significance of intrathecal infusion after fistula closure. In: Acta Medica Okayama. 2018 ; Vol. 72, No. 1. pp. 73-76.
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