背景:硬膜外蛛网膜囊肿(KAED)是一种罕见且良性的疾病,约占所有脊柱扩张性病变的1%。KAED的发病机制尚不确定,似乎是多因素的。脊柱压迫症状很少是指示性的,KAED通常是偶然发现的。MRI是首选的放射学测试,因为它可以精确表征囊肿。KAED的早期识别和管理对于预防并发症和确保及时干预至关重要。
方法:一名7岁游牧生活方式的女孩,表现为括约肌疾病,没有任何其他神经系统异常。进一步调查,包括生物测试,显示慢性肾衰竭.脊柱MRI识别出脊髓内硬膜外背腰蛛网膜囊肿,从D10延伸到L1,位于后方。及时切除囊肿,术后预后良好。该患者因慢性肾功能不全而接受vitaminocalcic和军事补充剂治疗,并在咨询后进行定期随访,出院。
■蛛网膜囊肿是一种罕见的良性疾病,可以偶然发现(Agnoli等人。,1982年;Chan等人。;1985)。症状是囊肿对脊髓施加压迫的结果,它们根据脊髓或神经根的压迫程度而变化。但症状形式是一种很少描述的情况(Charisseauj等人。,1992).在这种特殊情况下,由于一系列与急性肾功能不全有关的症状,发现了囊肿,这加剧了先前存在的慢性肾功能不全。这进一步使未经治疗的括约肌疾病复杂化。这突出了及时诊断和治疗以防止可能由良性疾病发展的严重并发症的重要性。通过早期干预,大多数患者都可以获得良好的结果(Kendall等人。,1982).
结论:随着神经影像学的发展和MRI作为金标准的广泛普及,现在可以在无症状患者中偶然发现硬膜外蛛网膜囊肿(KAED)。一旦确诊,通常建议手术干预以防止不可逆的神经损伤.需要进一步的研究,以更好地了解KAED的发病机制,并建立最佳的诊断和治疗策略。特别是在儿科患者中,这种罕见的情况。
BACKGROUND: Extradural arachnoid cyst (KAED) is a rare and benign condition, accounting for approximately 1 % of all spinal expansive lesions. The pathogenesis of KAED is uncertain and appears to be multifactorial. Spinal compression symptoms are rarely indicative, and KAED is usually discovered incidentally. MRI is the radiological test of choice as it allows for precise characterization of the cyst. Early identification and management of KAED is crucial to prevent complications and ensure timely intervention.
METHODS: A 7-year-old girl with a nomadic lifestyle presented with sphincterian disorders without any other neurological abnormalities. Further investigation, including biological tests, revealed chronic kidney failure. A spinal MRI identified an intra-spinal extradural dorso-lumbar arachnoid cyst extending from D10 to L1, located posteriorly. The cyst was promptly removed with favorable postoperative outcomes. The patient was discharged with a treatment of vitaminocalcic and martial supplementation for his chronic renal insufficiency and a regular follow-up in consultation.
UNASSIGNED: Arachnoid cyst is a rare benign condition that can be discovered incidentally (Agnoli et al., 1982; Chan et al.; 1985). The symptoms are the results of compression exerted by the cyst on the cord and they vary according to the level of compression of the spinal cord or the nerve roots, but the symptomatic form is a situation which remains rarely described (Charisseauj et al., 1992). In this particular
case, the cyst was identified due to a series of symptoms related to acute renal insufficiency, which exacerbated pre-existing chronic renal insufficiency. This was further complicating untreated sphincter disorders. This highlights the significance of timely diagnosis and treatment to prevent severe complications that may otherwise develop from a benign condition. With early intervention, favorable outcomes can be achieved in most patients (Kendall et al., 1982).
CONCLUSIONS: With the advancement of neuroimaging and the widespread availability of MRI as the gold standard, extradural arachnoid cysts (KAED) can now be incidentally discovered in asymptomatic patients. Once diagnosed, surgical intervention is typically recommended to prevent irreversible neurological damage. Further research is needed to better understand the pathogenesis of KAED and establish optimal diagnosis and treatment strategies, particularly in pediatric patients, for this rare condition.