Case Report
Surgical treatment with dye injection for symptomatic spinal intradural arachnoid cysts
2020 Volume 11 Issue 7 Pages 980-984
Details
2020 Volume 11 Issue 7 Pages 980-984
Introduction: It is very important to normalise the circulation of cerebrospinal fluid (CSF) in symptomatic spinal intradural arachnoid cysts (SIACs) by surgical treatment. We intraoperatively administered a dye injection into a SIAC to precisely determine the borderline of the SIAC. In this paper, we report our surgical procedure with a dye injection.
Case Report: A 76-year old man presented with severe bilateral leg pain. Magnetic resonance imaging revealed a cystic lesion that compressed the spinal cord from the dorsal side at vertebral level Th5-7. After dural incision via osteoplastic laminotomy at Th5-7, a SIAC was observed. Diluted pyoktanin blue was injected into the SAC, and the dye was not washed out immediately. It was indicated that the circulation of CSF in the SIAC was almost completely blocked. Hence, total removal of the dyed cyst membrane was safely accomplished. The patient immediately experienced relief of his leg pain after the surgery.
Conclusions: When the CSF circulation in a SIAC is blocked, we previously selected to perform total removal of the cyst. Dye injection into the SIAC can not only distinguish between the cyst wall and pia, but also the CSF circulation.
