Symptomatic idiopathic noncommunicating intradural XXXX : a case report.

@entity1 @entity1183 @entity809 @entity3491 @entity425 @entity145 @entity158
STUDY DESIGN: A case report of a rare symptomatic, idiopathic, noncommunicating intradural @entity145 (IAC) of the proximal part of the S1 nerve root (NR). OBJECTIVE: To discuss the possible pathophysiology, clinical and magnetic resonance imaging (MRI) presentation, intraoperative findings, and follow-up of IAC of the proximal part of the S1 NR. SUMMARY OF BACKGROUND DATA: Rare variety of the Nabors's Type 3 spinal IAC. The etiopathogenesis are uncertain. Surgical NR decompression with extirpation of the cyst is the treatment of choice. METHODS: A 37-year-old @entity1 clinically presented as monoradiculopathy with a 9-month history of progressive, posture-dependent @entity158 , @entity809 and @entity1183 in the right S1 dermatome, and mild @entity425 . Magnetic resonance imaging (MRI) showed a noncommunicating IAC of the proximal part of the S1 NR on the right side. Surgical exploration through the ipsilateral L5-S1 hemilaminectomy was performed with microsurgical arachnolysis of the compressed and stretched S1 NR fascicles that surrounded the cyst, during which the cyst spontaneously collapsed. The remnant of the cyst wall was extirpated and histopathology confirmed the diagnosis. RESULTS: After surgery an excellent clinical outcome was archived: the leg @entity158 was no longer present and the paraesthesia, @entity1183 , and motor weakness were resolved within 3 months. At 12 months of follow-up, the @entity1 continues to be completely asymptomatic with no evidence of recurrence on MRI. CONCLUSION: A rare case of symptomatic, idiopathic, noncommunicating IAC of the proximal part of the S1 NR has been presented. Early recognition and treatment resulted in complete symptom resolution, with preservation of the full working capacity and good quality of life. @entity3491 with progressive, posture-dependent @entity158 seem to be typical clinical findings for such a lesion. Attending physicians should always be mindful of this fact in the total clinical evaluation of such cases.
