Insidious progression of paraparesis secondary to type III spinal meningeal cyst: a study of six difficult cases.

Abstract

Case report. Neuro-orthopaedic Unit, Fukui University Hospital, Japan. We studied six patients with insidious progression of paraparesis caused by thoracic and thoracolumbar spine type III spinal meningeal cyst and intradural arachnoid cyst, who underwent microsurgical decompression. Histologically, some samples showed oedematous and hypertrophic changes of the arachnoidal tissue together with occasional tophaceous deposits and calcification. Surgical treatment was complete excision of the cyst, or wide fenestration of these membrane, and close a communicating fistula, if detectable. All patients improved neurologically after microscopic surgery. We stress the significance of neuroimaging and neurological assessment in patients with gradual progression of paraparesis caused by intradural arachnoid cyst, but surgical procedure and timing of operative intervention require further considerations.