Presentation
Chronic back pain, worsening for past one year. No urinary incontinence or lower limb weakness.
Patient Data
Multi-loculated cystic collection/masses with the same MR characteristic and intensities as cerebral spinal fluid from T10 till L3 vertebral levels. Extension to the bilateral neuro foraminae in these levels. The exiting nerve roots in these neuro foraminae are not observed. These collections/masses are located in extradural location as evidenced by displacing the normal thecal sac anteriorly seen in axial view.
No Tarlov cyst or sacral meningocele. Post contrast administration, no appreciable contrast enhancement of these lesions/collection.
Annotated image denotes the extradural location of the CSF intensity lesions.
Case Discussion
Spinal meningeal cysts (Nabor et al classification) type Ia for spinal meningeal/arachnoid cyst. Determine the location of the spinal lesion, whether intramedullary, intradural extramedullary or extradural locations are crucial for formulating differential diagnoses.
Absence of significant enhancement and the extradural location rule out the possibility of multiple schwannoma -cystic /nerve sheath tumors.
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