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Lumbar intraspinal arachnoid cyst superimposed by hyperacute spinal subdural hematoma: an unusual case.
Spine J. 2011 Jul; 11(7):e5-8.SJ

Abstract

BACKGROUND CONTEXT

Lumbar intradural arachnoid cyst (AC) concomitant with hyperacute spinal subdural hematoma (SSDH) has never been reported in the literature.

PURPOSE

To report a case of lumbar AC superimposed by hyperacute SSDH, which was difficult to diagnose preoperatively using magnetic resonance imaging. Herein, we describe diagrams showing the proposed mechanisms underlying the formation of a symptomatic AC.

STUDY DESIGN/SETTING

The study was designed to be a case report and literature review.

METHODS

A 65-year-old man presented with acute onset of low back pain, followed by 5-day history of numbness and weakness in both legs before admission. Magnetic resonance imaging of the lumbosacral spine revealed an intradural extramedullary biconvex lesion at the L3-L4 level; the lesion compressed the cauda equina posteriorly. The lesion mainly appeared as hyperintense on T2-weighted images and hypointense on T1-weighted images. On the basis of these findings, the lesion was preoperatively diagnosed as a symptomatic lumbar subdural AC that compressed the cauda equina.

RESULTS

The patient underwent laminectomy from L2 to L4. After a dura incision, a partially organized subdural hematoma was noted. Beneath the subdural hematoma was an AC compressing the underlying nerve roots. The patient's back pain and muscle strength markedly improved after the operation.

CONCLUSIONS

Preoperative diagnosis of concomitant hyperacute SSDH and AC is difficult. In cases of patients who present with intraspinal AC accompanied by an acute onset of clinical presentation, an associated etiology should be considered until proven otherwise.

Authors+Show Affiliations

Section of Neurosurgery, Department of Surgery, Chia-Yi Christian Hospital, Chia-yi 600, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

21530415

Citation

Huang, Kuo-Chang, et al. "Lumbar Intraspinal Arachnoid Cyst Superimposed By Hyperacute Spinal Subdural Hematoma: an Unusual Case." The Spine Journal : Official Journal of the North American Spine Society, vol. 11, no. 7, 2011, pp. e5-8.
Huang KC, Chuang MT, Huang DW, et al. Lumbar intraspinal arachnoid cyst superimposed by hyperacute spinal subdural hematoma: an unusual case. Spine J. 2011;11(7):e5-8.
Huang, K. C., Chuang, M. T., Huang, D. W., Fang, W. K., Chen, S. H., & Lee, J. S. (2011). Lumbar intraspinal arachnoid cyst superimposed by hyperacute spinal subdural hematoma: an unusual case. The Spine Journal : Official Journal of the North American Spine Society, 11(7), e5-8. https://doi.org/10.1016/j.spinee.2011.04.001
Huang KC, et al. Lumbar Intraspinal Arachnoid Cyst Superimposed By Hyperacute Spinal Subdural Hematoma: an Unusual Case. Spine J. 2011;11(7):e5-8. PubMed PMID: 21530415.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lumbar intraspinal arachnoid cyst superimposed by hyperacute spinal subdural hematoma: an unusual case. AU - Huang,Kuo-Chang, AU - Chuang,Ming-Tsung, AU - Huang,Da-Wei, AU - Fang,Wen-Kuei, AU - Chen,Shih-Han, AU - Lee,Jung-Shun, Y1 - 2011/05/06/ PY - 2010/09/13/received PY - 2011/01/16/revised PY - 2011/04/02/accepted PY - 2011/5/3/entrez PY - 2011/5/3/pubmed PY - 2011/12/16/medline SP - e5 EP - 8 JF - The spine journal : official journal of the North American Spine Society JO - Spine J VL - 11 IS - 7 N2 - BACKGROUND CONTEXT: Lumbar intradural arachnoid cyst (AC) concomitant with hyperacute spinal subdural hematoma (SSDH) has never been reported in the literature. PURPOSE: To report a case of lumbar AC superimposed by hyperacute SSDH, which was difficult to diagnose preoperatively using magnetic resonance imaging. Herein, we describe diagrams showing the proposed mechanisms underlying the formation of a symptomatic AC. STUDY DESIGN/SETTING: The study was designed to be a case report and literature review. METHODS: A 65-year-old man presented with acute onset of low back pain, followed by 5-day history of numbness and weakness in both legs before admission. Magnetic resonance imaging of the lumbosacral spine revealed an intradural extramedullary biconvex lesion at the L3-L4 level; the lesion compressed the cauda equina posteriorly. The lesion mainly appeared as hyperintense on T2-weighted images and hypointense on T1-weighted images. On the basis of these findings, the lesion was preoperatively diagnosed as a symptomatic lumbar subdural AC that compressed the cauda equina. RESULTS: The patient underwent laminectomy from L2 to L4. After a dura incision, a partially organized subdural hematoma was noted. Beneath the subdural hematoma was an AC compressing the underlying nerve roots. The patient's back pain and muscle strength markedly improved after the operation. CONCLUSIONS: Preoperative diagnosis of concomitant hyperacute SSDH and AC is difficult. In cases of patients who present with intraspinal AC accompanied by an acute onset of clinical presentation, an associated etiology should be considered until proven otherwise. SN - 1878-1632 UR - https://www.unboundmedicine.com/medline/citation/21530415/Lumbar_intraspinal_arachnoid_cyst_superimposed_by_hyperacute_spinal_subdural_hematoma:_an_unusual_case_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1529-9430(11)00252-X DB - PRIME DP - Unbound Medicine ER -