Cervical Cerebrospinal Fluid Leakage Concomitant with a Thoracic Spinal Intradural Arachnoid Cyst
10.13004/kjnt.2019.15.e31
- Author:
Sanghyun HAN
1
;
Seung Won CHOI
;
Bum Soo PARK
;
Jeong Wook LIM
;
Seon Hwan KIM
;
Jin Young YOUM
Author Information
1. Department of Neurosurgery, Chungnam National University Hospital, School of Medicine, Chungnam National University, Daejeon, Korea. swchoi@cnu.ac.kr
- Publication Type:Case Report
- Keywords:
Cerebrospinal fluid leakage;
Intracranial hypotension;
Arachnoid cyst
- MeSH:
Adult;
Arachnoid;
Blood Patch, Epidural;
Cerebrospinal Fluid Leak;
Cerebrospinal Fluid;
Diplopia;
Disease Progression;
Headache;
Humans;
Intracranial Hypotension;
Laminectomy;
Magnetic Resonance Imaging;
Membranes;
Neck Pain;
Paraparesis;
Spinal Cord;
Subarachnoid Space
- From:Korean Journal of Neurotrauma
2019;15(2):214-220
- CountryRepublic of Korea
- Language:English
-
Abstract:
We encountered a very rare case of spontaneous spinal cerebrospinal fluid (CSF) leakage and a spinal intradural arachnoid cyst (AC) that were diagnosed at different sites in the same patient. These two lesions were thought to have interfered with the disease onset and deterioration. A 30-year-old man presented with sudden neck pain and orthostatic headache. Diplopia, ophthalmic pain, and headache deteriorated. CSF leakage was confirmed in C2 by radioisotope cisternography, and an epidural blood patch was performed. While his symptoms improved gradually, paraparesis suddenly progressed. Thoracolumbar magnetic resonance imaging (MRI) revealed an upper thoracic spinal intradural AC, which was compressing the spinal cord. We removed the outer membrane of the AC and performed fenestration of the inner membrane after T3-4 laminectomy. Postoperative MRI showed complete removal of the AC and normalized lumbar subarachnoid space. All neurological deficits including motor weakness, sensory impairment, and voiding function improved to normal. We present a case of spontaneous spinal CSF leakage and consecutive intracranial hypotension in a patient with a spinal AC. Our report suggests that if spinal CSF leakage and a spinal AC are diagnosed in one patient, even if they are located at different sites, they may affect disease progression and aggravation.
