Spinal Arachnoid Cysts Associated with Spinal Cord Infarction

源自脊髓梗塞之脊椎蛛網膜囊腫

10.6200/TCMJ.2012.9.1.08

張峻菁(Chun-Ching Chang)；周立偉(Li-Wei Chou)；林千琳(Chien-Lin Lin)；陳德誠(Der-Cherng Chen)；底淑葳(Shu-Wei Dee)；高木榮(Mu-Jung Kao)

蛛網膜囊腫 ； 脊髓梗塞 ； 蛛網膜炎 ； 脊髓空洞症 ； arachnoid cysts ； infarction ； spinal cord ； syringomyelia

北市醫學雜誌

9卷1期（2012 / 03 / 01）

84 - 91

英文

一位43歲有末期腎臟病變接受血液透析的病患，在一次的血液透析當中發生漸進性的左側腹部脹痛，接著伴隨急性發作之雙下肢無力。電腦斷層顯示有一左側輸卵管卵巢膿瘍並有乙狀結腸之壓迫。後續的脊椎磁振造影檢查發現胸椎第一節至第五節的脊髓梗塞可能由septic emboli導致。在三個月後追蹤之磁振造影則發現一個位於胸椎第五節至第七節硬脊膜內之縱向蛛網膜囊腫，病患因此雙下肢之麻木感向上擴展及姿勢性低血壓之症狀惡化，接受了手術，切除此囊腫，術後病患下肢無力情形逐漸恢復，且於術後八個月後可自行行走。

A 43-year-old woman with end-stage renal disease suffered from progressive left abdominal distension and pain; this was accompanied by an acute onset of bilateral lower limb weakness during her renal dialysis. Computed tomography revealed a left tubulo-ovarian abscess with compression of the sigmoid colon. Magnetic resonance imaging (MRI) revealed a T-1 to T-5 spinal cord infarction that might have been caused by septic emboli. During an MRI follow-up after three-months, a longitudinal intradural arachnoid cyst at T-5 to T-7 level of the spinal cord was discovered. Surgical intervention to remove the arachnoid cyst was performed due to increasing numbness of lower limbs and worsening orthostatic hypotension. The patient's recovery was excellent and she could walk for short distances independently eight months after the operation.