ABSTRACT
BACKGROUND: Spinal bronchogenic cysts are rare nonneoplastic congenital variants of neurenteric cysts. The natural history and surgical management of these lesions are poorly understood. OBSERVATIONS: A 25-year-old male presented with progressive back pain and bilateral lower limb sciatica of 6 months' duration. He had undergone subtotal resection of an intramedullary bronchogenic conus medullaris cyst 5 years prior. Magnetic resonance imaging revealed a recurrent bilobed intramedullary and extramedullary conus medullaris cystic lesion. The authors resected the lesion via a posterior approach with the aid of intraoperative neuromonitoring. Gross total resection was precluded by the tightly adherent nature of the cyst and the fact that stimulation of a residual intramedullary portion of the lesion evoked external anal sphincter responses. LESSONS: This is the first reported case of a bilobed intramedullary and extramedullary bronchogenic cyst of the conus medullaris. This unique case lends insight into the poorly defined embryogenesis of bronchogenic cysts by favoring the split notochord syndrome theory rather than the ectopic ectoderm proposal. The importance of neuromonitoring when resecting these tightly adherent lesions is demonstrated. Finally, although the secretory nature of these lesions portends a tendency for cyst reaccumulation, it is imperative to recognize that this is usually a slow process.
ABSTRACT
More than 50 years ago, Hubel and Wiesel identified a subpopulation of geniculate magnocellular (M) neurons that are suppressed by diffuse red light. Since then, many human psychophysical studies have used red and green backgrounds to study the effects of M suppression on visual task performance, as a means to better understand neurodevelopmental disorders such as dyslexia and schizophrenia. Few of these studies have explicitly assessed the relative effects of red backgrounds on the M and P (parvocellular) pathways. Here we compared the effects of red and green diffuse background illumination on well-accepted cortical M and P signatures, both physiologically through nonlinear analysis of visual evoked potentials (VEPs; N = 15), and psychophysically through pulsed and steady pedestal perceptual thresholds (N = 9 with gray pedestals and N = 8 with colored pedestals). Red surrounds reduced P-generated temporal nonlinearity in the VEPs, but they did not influence M-generated VEP signatures. The steady and pulsed pedestal results suggest that red surrounds can have different effects on M and P contrast sensitivities, depending on whether the target is colored gray or red, presented centrally or peripherally, or whether it is brighter or dimmer than the surround. Our results highlight difficulties in interpreting the effects of red backgrounds on human VEPs or perception in terms of M specific suppression.
