Tc. Kriss et Vm. Kriss, SYMPTOMATIC SPINAL INTRADURAL ARACHNOID CYST DEVELOPMENT AFTER LUMBARMYELOGRAPHY - CASE-REPORT AND REVIEW OF THE LITERATURE, Spine (Philadelphia, Pa. 1976), 22(5), 1997, pp. 568-572
Study Design. This case report describes the unique occurrence of acqu
ired intradural spinal arachnoid cyst after lumbar puncture, which was
proven radiographically and surgically. Objectives. To review and exp
lore complications Of lumbar puncture in the context of subsequent cys
t development and to review the incidence, presentation, pathogenesis,
and management of spinal intradural arachnoid cysts. Summary of Backg
round Data. The etiology of the spinal intradural arachnoid cyst remai
ns obscure; some such cysts are ascribed anecdotally to previous traum
a or arachnoiditis, whereas the majority are idiopathic and assumed by
many authors to congenital. Methods. A 20-year-old woman with back an
d leg pain underwent lumbar myelography that yielded normal results wi
th no evidence of arachnoid cyst at that time. With 5 months, clinical
symptoms of cauda equina compression and an S1 radiculopathy develope
d. Subsequent myelography and magnetic resonance imaging revealed a lu
mbar spinal arachnoid cyst. There was no history of intervening trauma
or arachnoiditis. The lumbar puncture was thought to be the cause of
the arachnoid cyst. Results. A laminectomy was performed with complete
excision of the arachnoid cyst. The patient had an unremarkable posto
perative course with excellent relief of her symptoms. Conclusions. Th
is case provides supporting evidence for the traumatic etiology of spi
nal intradural arachnoid cyst. The development of an intradural spinal
arachnoid cyst should be included as a possible implication of lumbar
puncture.