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Periodontoid Synovial Cyst Causing Cervico-medullary Compression

Published online by Cambridge University Press:  18 September 2015

Anthony M. Kaufmann*
Affiliation:
Section of Neurosurgery, University of Manitoba
William C. Halliday
Affiliation:
Department of Pathology (WCH), University of Manitoba
Michael West
Affiliation:
Section of Neurosurgery, University of Manitoba
Derek Fewer
Affiliation:
Section of Neurosurgery, University of Manitoba
Ian Ross
Affiliation:
Section of Neurosurgery, University of Manitoba
*
Department of Neurological Surgery, University of Pittsburgh. Suite B-400, 200 Lothrop Street Pittsburgh PA 15213-2582, U.S.A.
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Abstract

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Background: Periodontoid synovial cysts are rare lesions which may produce symptomatic cervico-medullary compression. Method: We report such a patient, whose progressive neurological deterioration required surgical treatment by transoral odontoidectomy and decompression. Results: The diagnostic and theraputic interventions are described, including a lumbar puncture which precipitated a transient loss of consciousness and respiratory arrest. Surgery achieved clinical improvement, without complications or need for operative stablization. Detailed neuropathology is presented, as well as a literature review. Conclusion: Appropriate neuroradiological assessment is required in patients with suspected cervico-medullary compression, and symptomatic periodontoid synovial cysts may respond well to transoral surgical decompression.

Résumé

Résumé

Kyste synovial périodontoïde causant des compressions cervicomédullaires. Introduction: Les kystes synoviaux périodontoïdes sont des lésions rares qui peuvent causer des compressions cervicomédullaires symptomatiques. Méthodes: Nous rapportons le cas d’un patient présentant une détérioration neurologique progressive qui a du être traité chirurgicalement par odontoïdectomie transorale et décompression. Résultats: Nous décrivons les interventions diagnostiques et thérapeutiques, dont la ponction lombaire compliquée d’une perte de conscience transitoire et d’un arrêt respiratoire. La chirurgie a amené une amélioration clinique sans complication et sans stabilisation opératoire. Nous présentons un rapport neuropathologique détaillé ainsi qu’une revue de la littérature. Conclusions: Les patients chez qui on soupçonne une compression cervico-médullaire doivent subir une évaluation neuroradiologique appropriée. La décompression chirurgicale transorale peut donner de bons résultats dans les kystes périodontoïdes symptomatiques.

Type
Original Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1996

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