The value of different neuro-imaging methods in the diagnosis of a congenital, spinal, epidural meningeal cyst.

Congenital, spinal, epidural cysts are rare causes of transverse or radicular spinal lesions. Usually these cysts are located in the thoracal region, are oblong-shaped, and extend over several segments dorsally to the cord. Frequently, they cause no symptoms for years. They are fairly accessible to diagnostics by modern neuro-imaging methods. We report on a 15 year old girl with paraparesis, which showed a slow progression over two years, short-term remissions, and finally impairment of bladder function. Myelogram, computer-assisted tomography and nuclear magnetic resonance tomography showed a large space-occupying mass from D8 to L1 epidural and dorsal of the myelon. Operation disclosed an epidural cyst from D10 to L2. Histologically, the removed material was classified as a meningeal cyst. Post-operatively the girl's condition improved under intensive physio-therapy. For the diagnosis of this spinal dysrhapic disorder CT scanning after intrathecal application of contrast medium and magnetic resonance imaging were most valuable.

[Value of cervical myelography in lateral cervical root compression]. / Aussagekraft der zervikalen Myelographie bei der lateralen zervikalen Wurzelkompression.

The roentgenograms of preoperative cervical metrizamide myelography performed in 133 patients who had undergone surgery for a lateral cervical root compression (foraminotomy) were retrospectively re-evaluated without knowledge of the findings at surgery. Detailed criteria of the radiologic root cavity recess were compared with details of findings at surgery, in order to check the value of the information provided by the myelogram with regard to the morphological nature of the root compression. A review of the two main categories--"soft prolapse with or without primary sequestrum" and "hard protrusion" revealed different myelographic findings. It was not possible to establish an unequivocal diagnosis in individual cases and with regard to forms of root compression exhibiting a greater degree of differentiation.