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Intraspinal Neurenteric Cysts in Children

Published online by Cambridge University Press:  02 December 2014

Chunquan Cai ,
Changhong Shen ,
Weidong Yang ,
Qingjiang Zhang  and
Xiaoli Hu
Chunquan Cai
Affiliation:
Department of Neurosurgery, General Hospital of Tianjin Medical University Department of Pediatric Neurosurgery, Tianjin Children's Hospital, Tianjin, P.R. China
Changhong Shen*
Affiliation:
Department of Neurosurgery, General Hospital of Tianjin Medical University
Weidong Yang
Affiliation:
Department of Neurosurgery, General Hospital of Tianjin Medical University
Qingjiang Zhang
Affiliation:
Department of Pediatric Neurosurgery, Tianjin Children's Hospital, Tianjin, P.R. China
Xiaoli Hu
Affiliation:
Department of Pathology, Tianjin Children's Hospital, Tianjin, P.R. China
*
Department of Neurosurgery, General Hospital of Tianjin Medical University, No. 54, Anshan Road, Heping District, Tianjin 300052, P. R. China.
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Abstract

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Background:

Neurenteric cysts are rare congenital epithelium-lined cysts of the central nervous system. They are found predominantly in the spinal cord, with lower incidence in the intracranial compartment, and may be associated with various other congenital spinal anomalies. Seven patients with symptomatic intraspinal neurenteric cysts are presented.

Materials and Methods:

Seven patients with intraspinal neurenteric cysts aged from nine months to ten years treated at this hospital from May 2000 to July 2006 were reviewed. The clinical manifestations, imaging and surgical findings of patients were analyzed retrospectively. All patients underwent operation. One patient's cervical neurenteric cyst was resected using the lateral cervical approach, and the other six resections were performed with posterior approach.

Results:

All seven patients presented with neurological involvement. One patient had an intramedullary cyst, while the other six cysts were situated ventrally. Three patients' cysts occurred in the cervical region, two in the cervicothoracic region, one in the thoracic region and one in the lumbar region. One patient had bony anomalies, and one had a lumbar posterior occult spinal dysraphism. Five patients' symptoms improved rapidly after surgery.

Conclusions:

Intraspinal neurenteric cysts in children are rare and most occur ventral to the spinal cord. Magnetic resonance imaging (MRI) is the most effective imaging modality. Earlier diagnosis and surgical resection of spinal neurenteric cysts improves prognosis.

Résumé:

RÉSUMÉ:Contexte:

Les kystes neuroentériques sont des kystes congénitaux rares qui sont tapissés d'épithélium et localisés dans le système nerveux central. On les retrouve surtout au niveau de la moelle épinière et moins fréquemment au niveau intracrânien. Ils peuvent être associés à différentes anomalies spinales congénitales.

Matériel et méthodes:

Nous révisons les observations concernant sept patients porteurs d'un kyste neuroentérique intraspinal symptomatique, âgés de 9 mois à 10 ans, traités dans notre centre hospitalier entre mai 2000 et juillet 2006. Nous analysons rétrospectivement les manifestations cliniques, l'imagerie et les constatations chirurgicales chez ces patients. Tous les patients ont été opérés. Chez un patient, le kyste neuroentérique cervical a été enlevé par une approche cervicale latérale et chez les six autres par une approche postérieure.

Résultats:

Les sept patients ont consulté pour des troubles neurologiques. Un patient avait un kyste intramédullaire et les six autres un kyste situé antérieurement. Le kyste était situé à la région cervicale chez trois patients, à la région cervicothoracique chez deux, à la région thoracique chez un et à la région lombaire chez l'autre. Un patient présentait des anomalies osseuses et un patient présentait un dysraphisme spinal occulte à la région lombaire postérieure. Chez cinq patients les symptômes se sont améliorés rapidement après la chirurgie.

Conclusions:

Les kystes neuroentériques intraspinaux sont rares chez les enfants et la plupart sont situés à la région antérieure de la moelle épinière. L'IRM est la meilleure technique d'imagerie chez ces patients. Le pronostic est meilleur si le diagnostic et l'ablation chirurgicale sont plus précoces.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 35 , Issue 5 , November 2008 , pp. 609 - 615
Copyright
Copyright © The Canadian Journal of Neurological 2008

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