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Spinal Meningeal Cysts And Their Mimics – What Do We Need To Know? 2014

Category General Spine Ranjit K. Jain, MBBS, MD Samir Noujaim Purpose (1) To review the various type of spinal meningeal cysts with emphasis on their current nomenclature and classification system. (2) To discuss the pathophysiology and imaging of spinal meningeal cysts. (3) To review and illustrate their potential mimics. Materials & Methods The nomenclature and classification of meningeal cysts will be discussed using schematic diagrams. Cases of spinal meningeal cysts and their mimics gathered from our institute, a tertiary medical care center, will be used for illustration. We will also discuss how to differentiate meningeal cysts from their mimics, and the preferred modalities for imaging. Results Accurate diagnosis was achieved when the radiologists recognized the types of cyst and their mimics, and when the appropriate diagnostic imaging modality was used. Conclusion Spinal meningeal cysts are often confused with other cystic lesions. Knowledge of current classification system and nomenclature, use of appropriate imaging modality, and awareness of potential mimics will help a radiologist in making a correct diagnosis. Accurate diagnosis will guide treatment options. References 1. Nabors MW, Pait TG, Byrd EB et al. Updated assessment and current classification of spinal meningeal cysts. J Neurosurg 1988; 68:366–67. 2. Khosla A and Wippold FJ. CT myelography and MR imaging of extramedullary cysts of the spinal canal in adult and pediatric patients. AJR Am J Roentgenol 2002; 178:201–07. 3. Brus-Ramer M, Dillon WP. Idiopathic thoracic spinal cord herniation: retrospective analysis supporting a mechanism of diskogenic dural injury and subsequent tamponade. AJNR Am J Neuroradiol 2012; 33:52–56. 4. Dix ED, Griffitt W and Yates C et al. Spontaneous thoracic spinal cord herniation through an anterior dural defect. AJNR Am J Neuroradiol 1998; 19:1345–48.