Abstract
Objective: Of this study is identifying the clinical manifestations, discuss the etiology, and
present the surgical treatment nuances and outcomes of patients with sub dural arachnoidal
cysts (AC). Method: A retrospective study was carried out with 7 consecutives patients with spinal cord
subdural AC, diagnosed, evaluated and operated at the Neurosurgical department of
Servidores do Estado Hospital, from 1996 to 2010. The radiological studies, patient
records, surgical descriptions and surgical videos, were reviewed, creating a database
from which information was collected. The follow-up varied from 2 to 168 months (mean,
48 months). All cysts were histopathological verified. Results: Five AC were located on the thoracic spinal cord, one were located anterior in the
cervical region, and one at the lumbar spinal level. The complete resection of the
cyst was performed in 4 surgeries. Three patients had cysts located ventral to the
cord, which precluded complete excision. The symptoms in four patients demonstrated
major improvement. There was no operative death in this series, there was no major
complications related to surgery. Conclusion: AC should be considered in the differential diagnosis of lesions causing myelopathy
and/or a radicular pain syndrome. Microsurgical resection or generous fenestration
in cysts effectively ameliorated patients’ symptomatology.
Resumo
Objetivo: Identificar as manifestações clínicas, discutir a etiologia, apresentar as opções
terapêuticas e revelar os resultados de uma série de pacientes diagnosticados com
cisto aracnoide medular subdural (CA). Método: Realizamos um estudo retrospectivo em que analisamos 7 pacientes com AC que foram
operados no Hospital dos Servidores do Estado, entre 1996 e 2010. Os estudos de imagem,
prontuários, descrições cirúrgicas e os vídeos foram analisados e os dados, coletados.
O seguimento variou de 8 a 168 meses. Em todos os cistos foi realizado estudo histopatológico.
Resultados: Cinco cistos se localizavam na medula torácica, um na cervical anterior e outro no
segmento lombar. Obtivemos a excisão completa dos cistos em 4 pacientes, que apresentaram
importante melhora dos sintomas. Não ocorreu nenhum óbito nessa série, nem piora do
sintomas pré-operatórios. Conclusão: O CA deve ser considerado no diagnóstico diferencial das lesões que causam mielopatia
ou síndrome radicular. A ressecção microcirúrgica ou uma ampla fenestração das paredes
do cisto geralmente revertem os sintomas do pacientes.
Keyword
Arachnoid cysts - spinal cord compression - sciatica - myelitis - microsurgery
Palavras-chave
Cistos aracnóideos - compressão da medula espinal - ciática - mielite - microcirurgia
