PDF(Pubmed)
Abstract：
Objectives This article reports the management of a case of a 32-year-old male who presented with progressive weakness in the lower limbs and spastic paraparesis secondary to an intramedullary arachnoid cyst (IMAC). For literature review, the authors used the phrase \"intramedullary arachnoid cyst\" in PubMed search engine. 23 articles describing cases with IMAC were included in this review, with a total of 26 patients. Materials and Methods We report a case with long term recurrant intramedullary arachnoid cyst and present a review on spinal intramedullary arachnoid cyst. Result IMAC is showing bimodal incidence and trending to occur below 10 years and after 30 years. However, rarely, it should be considered in the differential diagnosis of intramedullary cystic lesions. Authors suggest doing laminoplasty or fusion for the pediatric patients to prevent kyphoscoliosis deformity in the long run, but doing early surgery to gain better outcome. Resection of the cyst wall should be done as much as possible; if it could not be achieved, then marsupialization or cysto-subarachnoid shunt should be considered. Aspiration alone or fenestration is not enough to eradicate the cyst. Long-term and prospective studies are recommended to achieve the best treatment options. Conclusion Review supports early surgical treatment of symptomatic IMACs with resection of the cyst wall as much as possible.
摘要：
目的本文报告了一例32岁男性的治疗方法，该男性表现为下肢进行性无力和继发于髓内蛛网膜囊肿（IMAC）的痉挛性轻瘫。对于文献综述，作者在PubMed搜索引擎中使用了术语“髓内蛛网膜囊肿”。本综述包括23篇描述IMAC病例的文章，共26名患者。材料与方法我们报告了1例长期复发的髓内蛛网膜囊肿，并对脊髓髓内蛛网膜囊肿进行了综述。结果IMAC显示出双峰发病率和趋势，在10年以下和30年后发生。然而,很少,髓内囊性病变的鉴别诊断应考虑。作者建议对儿科患者进行椎板成形术或融合术，以防止脊柱后凸畸形，从长远来看，而是做早期手术以获得更好的结果。应尽可能切除囊肿壁；如果不能实现，则应考虑有袋化或膀胱蛛网膜下腔分流术。单独抽吸或开窗不足以根除囊肿。建议进行长期和前瞻性研究以达到最佳治疗方案。结论Review支持对症IMAC的早期手术治疗，并尽可能切除囊肿壁。
