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Sacral Extradural Arachnoid Cyst
Kevin R. Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Sacral meningeal cyst, type IB meningeal cyst
              • Definitions

                • Spinal extradural arachnoid cyst (AC) localized to sacrum

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Nonvascular Interventions

                          • Other Modality Findings

                            • Imaging Recommendations

                              DIFFERENTIAL DIAGNOSIS

                                PATHOLOGY

                                • General Features

                                  • Staging, Grading, & Classification

                                    • Gross Pathologic & Surgical Features

                                      • Microscopic Features

                                        CLINICAL ISSUES

                                        • Presentation

                                          • Demographics

                                            • Natural History & Prognosis

                                              • Treatment

                                                DIAGNOSTIC CHECKLIST

                                                • Consider

                                                  • Image Interpretation Pearls

                                                    Selected References

                                                    1. Satyarthee GD: Pediatric symptomatic sacral extradural arachnoid cyst: surgical management review. J Pediatr Neurosci. 13(2):211-3, 2018
                                                    2. Tanaka T et al: Electrodiagnostic and advanced neuroimaging characterization for successful treatment of spinal extradural arachnoid cyst. World Neurosurg. 109:298-303, 2018
                                                    3. Habibi Z et al: Sacral extradural arachnoid cyst in association with split cord malformation. Spine J. 16(9):1109-15, 2016
                                                    4. Azad R et al: Role of screening of whole spine with sagittal MRI with MR myelography in early detection and management of occult intrasacral meningocele. Asian J Neurosurg. 8(4):174-8, 2013
                                                    5. Lohani S et al: Intrasacral meningocele in the pediatric population. J Neurosurg Pediatr. 11(6):615-22, 2013
                                                    6. Bond AE et al: Spinal arachnoid cysts in the pediatric population: report of 31 cases and a review of the literature. J Neurosurg Pediatr. 9(4):432-41, 2012
                                                    7. Vaccaro M et al: A woman with abdominal pain and headache. Neurol Sci. 30 Suppl 1:S141-3, 2009
                                                    8. Hamamcioglu MK et al: Intrasacral extradural arachnoid cysts. Neurol Med Chir (Tokyo). 48(5):223-6, 2008
                                                    9. Liu JK et al: Spinal extradural arachnoid cysts: clinical, radiological, and surgical features. Neurosurg Focus. 22(2):E6, 2007
                                                    10. Choi JY et al: Spinal extradural arachnoid cyst. Acta Neurochir (Wien). 148(5):579-85; discussion 585, 2006
                                                    11. Nishio Y et al: A case of occult intrasacral meningocele presented with atypical bowel symptoms. Childs Nerv Syst. 20(1):65-7, 2004
                                                    12. Sato K et al: Spinal extradural meningeal cyst: correct radiological and histopathological diagnosis. Neurosurg Focus. 13(4):ecp1, 2002
                                                    13. Diel J et al: The sacrum: pathologic spectrum, multimodality imaging, and subspecialty approach. Radiographics. 21(1):83-104, 2001
                                                    14. Patel MR et al: Percutaneous fibrin glue therapy of meningeal cysts of the sacral spine. AJR Am J Roentgenol. 168(2):367-70, 1997
                                                    15. Okada T et al: Occult intrasacral meningocele associated with spina bifida: a case report. Surg Neurol. 46(2):147-9, 1996
                                                    16. Doi H et al: Occult intrasacral meningocele with tethered cord--case report. Neurol Med Chir (Tokyo). 35(5):321-4, 1995
                                                    17. Tatagiba M et al: Management of occult intrasacral meningocele associated with lumbar disc prolapse. Neurosurg Rev. 17(4):313-5, 1994
                                                    18. Davis SW et al: Sacral meningeal cysts: evaluation with MR imaging. Radiology. 187(2):445-8, 1993
                                                    19. Bayar MA et al: Management problems in cases with a combination of asymptomatic occult intrasacral meningocele and disc prolapse. Acta Neurochir (Wien). 108(1-2):67-9, 1991
                                                    20. Doty JR et al: Occult intrasacral meningocele: clinical and radiographic diagnosis. Neurosurgery. 24(4):616-25, 1989
                                                    21. Nabors MW et al: Updated assessment and current classification of spinal meningeal cysts. J Neurosurg. 68(3):366-77, 1988
                                                    22. Goyal RN et al: Intraspinal cysts: a classification and literature review. Spine. 12(3):209-13, 1987
                                                    23. Genest AS: Occult intrasacral meningocele. Spine. 9(1):101-3, 1984
                                                    24. Grivegnee A et al: Comparative aspects of occult intrasacral meningocele with conventional X-ray, myelography and CT. Neuroradiology. 22(1):33-7, 1981
                                                    25. Fortuna A et al: Arachnoid diverticula: a unitary approach to spinal cysts communicating with the subarachnoid space. Acta Neurochir (Wien). 39(3-4):259-68, 1977
                                                    26. Lamas E et al: Occult intrasacral meningocele. Surg Neurol. 8(3):181-4, 1977
                                                    27. Lombardi G et al: Congenital cysts of the spinal membranes and roots. Br J Radiol 36:197-205, 1963
                                                    Related Anatomy
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                                                    Related Differential Diagnoses
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                                                    References
                                                    Tables

                                                    Tables

                                                    KEY FACTS

                                                    • Terminology

                                                      • Imaging

                                                        • Top Differential Diagnoses

                                                          • Pathology

                                                            • Clinical Issues

                                                              • Diagnostic Checklist

                                                                TERMINOLOGY

                                                                • Synonyms

                                                                  • Sacral meningeal cyst, type IB meningeal cyst
                                                                • Definitions

                                                                  • Spinal extradural arachnoid cyst (AC) localized to sacrum

                                                                IMAGING

                                                                • General Features

                                                                  • Radiographic Findings

                                                                    • CT Findings

                                                                      • MR Findings

                                                                        • Ultrasonographic Findings

                                                                          • Nonvascular Interventions

                                                                            • Other Modality Findings

                                                                              • Imaging Recommendations

                                                                                DIFFERENTIAL DIAGNOSIS

                                                                                  PATHOLOGY

                                                                                  • General Features

                                                                                    • Staging, Grading, & Classification

                                                                                      • Gross Pathologic & Surgical Features

                                                                                        • Microscopic Features

                                                                                          CLINICAL ISSUES

                                                                                          • Presentation

                                                                                            • Demographics

                                                                                              • Natural History & Prognosis

                                                                                                • Treatment

                                                                                                  DIAGNOSTIC CHECKLIST

                                                                                                  • Consider

                                                                                                    • Image Interpretation Pearls

                                                                                                      Selected References

                                                                                                      1. Satyarthee GD: Pediatric symptomatic sacral extradural arachnoid cyst: surgical management review. J Pediatr Neurosci. 13(2):211-3, 2018
                                                                                                      2. Tanaka T et al: Electrodiagnostic and advanced neuroimaging characterization for successful treatment of spinal extradural arachnoid cyst. World Neurosurg. 109:298-303, 2018
                                                                                                      3. Habibi Z et al: Sacral extradural arachnoid cyst in association with split cord malformation. Spine J. 16(9):1109-15, 2016
                                                                                                      4. Azad R et al: Role of screening of whole spine with sagittal MRI with MR myelography in early detection and management of occult intrasacral meningocele. Asian J Neurosurg. 8(4):174-8, 2013
                                                                                                      5. Lohani S et al: Intrasacral meningocele in the pediatric population. J Neurosurg Pediatr. 11(6):615-22, 2013
                                                                                                      6. Bond AE et al: Spinal arachnoid cysts in the pediatric population: report of 31 cases and a review of the literature. J Neurosurg Pediatr. 9(4):432-41, 2012
                                                                                                      7. Vaccaro M et al: A woman with abdominal pain and headache. Neurol Sci. 30 Suppl 1:S141-3, 2009
                                                                                                      8. Hamamcioglu MK et al: Intrasacral extradural arachnoid cysts. Neurol Med Chir (Tokyo). 48(5):223-6, 2008
                                                                                                      9. Liu JK et al: Spinal extradural arachnoid cysts: clinical, radiological, and surgical features. Neurosurg Focus. 22(2):E6, 2007
                                                                                                      10. Choi JY et al: Spinal extradural arachnoid cyst. Acta Neurochir (Wien). 148(5):579-85; discussion 585, 2006
                                                                                                      11. Nishio Y et al: A case of occult intrasacral meningocele presented with atypical bowel symptoms. Childs Nerv Syst. 20(1):65-7, 2004
                                                                                                      12. Sato K et al: Spinal extradural meningeal cyst: correct radiological and histopathological diagnosis. Neurosurg Focus. 13(4):ecp1, 2002
                                                                                                      13. Diel J et al: The sacrum: pathologic spectrum, multimodality imaging, and subspecialty approach. Radiographics. 21(1):83-104, 2001
                                                                                                      14. Patel MR et al: Percutaneous fibrin glue therapy of meningeal cysts of the sacral spine. AJR Am J Roentgenol. 168(2):367-70, 1997
                                                                                                      15. Okada T et al: Occult intrasacral meningocele associated with spina bifida: a case report. Surg Neurol. 46(2):147-9, 1996
                                                                                                      16. Doi H et al: Occult intrasacral meningocele with tethered cord--case report. Neurol Med Chir (Tokyo). 35(5):321-4, 1995
                                                                                                      17. Tatagiba M et al: Management of occult intrasacral meningocele associated with lumbar disc prolapse. Neurosurg Rev. 17(4):313-5, 1994
                                                                                                      18. Davis SW et al: Sacral meningeal cysts: evaluation with MR imaging. Radiology. 187(2):445-8, 1993
                                                                                                      19. Bayar MA et al: Management problems in cases with a combination of asymptomatic occult intrasacral meningocele and disc prolapse. Acta Neurochir (Wien). 108(1-2):67-9, 1991
                                                                                                      20. Doty JR et al: Occult intrasacral meningocele: clinical and radiographic diagnosis. Neurosurgery. 24(4):616-25, 1989
                                                                                                      21. Nabors MW et al: Updated assessment and current classification of spinal meningeal cysts. J Neurosurg. 68(3):366-77, 1988
                                                                                                      22. Goyal RN et al: Intraspinal cysts: a classification and literature review. Spine. 12(3):209-13, 1987
                                                                                                      23. Genest AS: Occult intrasacral meningocele. Spine. 9(1):101-3, 1984
                                                                                                      24. Grivegnee A et al: Comparative aspects of occult intrasacral meningocele with conventional X-ray, myelography and CT. Neuroradiology. 22(1):33-7, 1981
                                                                                                      25. Fortuna A et al: Arachnoid diverticula: a unitary approach to spinal cysts communicating with the subarachnoid space. Acta Neurochir (Wien). 39(3-4):259-68, 1977
                                                                                                      26. Lamas E et al: Occult intrasacral meningocele. Surg Neurol. 8(3):181-4, 1977
                                                                                                      27. Lombardi G et al: Congenital cysts of the spinal membranes and roots. Br J Radiol 36:197-205, 1963