RESUMO
INTRODUCTION: Extradural arachnoid spinal cysts are unfrequent lesions that are associated with spinal trauma, surgery and less frequently with congenital anomalies. The clinical manifestations are similar to those seen with other compressive spinal cord lesions. Magnetic resonance techniques allow to diagnose correctly this pathology and to define its thopographic situation. The pathologic history of the patient is essencial to establish the ethiology. Surgery is the elective treatment in most cases. CLINICAL CASE: The patient is a 35 years old man who has a medical history of penetrating spinal trauma two years ago. In that instance he suffered an unilateral spinal cord section at D2-D3 level with the corresponding Brown Sequard syndrome. A small wound was detected at the skin dorsal level and it was closed without difficulties. At the beginning, he improved his motor right leg function with rehabilitation and vitamins. After two years of good recovery he came to our hospital suffering a neurological deterioration of six months of evolution. The physical examination revealed an spastic paraparesis. Magnetic resonance was performed demonstrating a cystic extradural collection compressing the spinal cord at D3-D4 level. Surgical decompressive treatment allowed to excise the cyst and it was possible to define a dural tear that was closed successfully. The outcome was good with restoration of the initial motor function that he had after the spinal trauma. CONCLUSIONS: Surgical management of postraumatic epidural arachnoid spinal cyst allows to detect the meningeal tear and to close it, which is highly effective on these kinds of lesions.
Assuntos
Cistos Aracnóideos/etiologia , Síndrome de Brown-Séquard/etiologia , Dura-Máter/cirurgia , Paraparesia Espástica/etiologia , Doenças da Medula Espinal/etiologia , Traumatismos da Medula Espinal/etiologia , Ferimentos Penetrantes/complicações , Adulto , Cistos Aracnóideos/patologia , Cistos Aracnóideos/cirurgia , Síndrome de Brown-Séquard/reabilitação , Descompressão Cirúrgica , Progressão da Doença , Dura-Máter/lesões , Espaço Epidural , Gliose/cirurgia , Humanos , Laminectomia , Imageamento por Ressonância Magnética , Masculino , Compressão da Medula Espinal/etiologia , Doenças da Medula Espinal/patologia , Doenças da Medula Espinal/cirurgia , Técnicas de Sutura , Vértebras TorácicasRESUMO
Os autores fazem revisäo de 9 casos submetidos a remoçäo cirúrgica da membrana epirretiniana na mácula. Houve 7 casos com melhora da visäo, 2 casos sem alteraçäo e nenhum apresentou piora