Cervicodorsal Diverticula of the Subarachnoid Space

Publisher Website
Google Scholar
Abstract
Localized saccular dilatations of the subarachnoid space overlying the lumbar nerve roots occur with moderate frequency (4). In the authors' experience, however, similar dilatations in the cervical and dorsal areas are relatively uncommon. The purpose of this paper is to report briefly 2 cases of asymptomatic diverticular extensions of the subarachnoid space overlying the eighth cervical nerve root and to indicate the roentgen findings which distinguish the entity from avulsion of the brachial plexus. CASE I: H. B., a 38-year-old male, was hospitalized July 10, 1957, because of cervical, shoulder, and arm pain on the left side. One week prior to admission, he was physically jarred while driving his car which was struck in the rear by a truck. He experienced stiffness of the neck and pain in the left cervical region which radiated into the corresponding shoulder and arm. Pain was aggravated and particularly precipitated by turning the head and neck to the right. The patient complained of intermittent tingling and weakness of the left hand as well. Physical examination revealed moderate tenderness over the left trapezius and supraclavicular and upper dorsal regions. Scalene tension tests on the left were positive. Passive neck rotation to the right and extension produced pain which was referred to the left arm and dorsal region. There was moderate restriction of active and passive cervical flexion. Good power was present in all four extremities without reflex abnormalities. Roentgenograms of the cervical spine showed moderate narrowing of the intervertebral disk space between the fifth and sixth cervical vertebrae with spur formation. Myelography was essentially negative except for a small diverticulum of the right eighth cervical root (Fig. 1). The clinical impression was musculoligamentous strain of the cervicodorsal region and the patient's symptoms subsided progressively with physiotherapy. CASE II: G. R., a 43-year-old housewife, was admitted to the hospital on Sept. 22, 1957, with complaints of headache, convulsions, and weakness of the right arm. Six years prior to admission the patient had a hysterectomy and shortly thereafter became aware of some weakness of the right arm and headache which remained rather persistent to the time of hospitalization. General clinical and neurological examinations were essentially negative except for hypertension (blood pressure 170/105 Hg). Conventional roentgenograms of the cervical spine showed narrowing of the intervertebral disk space between C5 and C6 with osteophyte formation anteriorly and posteriorly at this level. There was posterior spur formation at C4–5 as well. Roentgen studies of the skull were normal. Myelography demonstrated defects on the anterior aspect of the Pantopaque column at C4–5 and C5–6 corresponding to the sites of the posterior spurs. There was also a small diverticulum of the left eighth cervical nerve root (Fig. 2).

This publication has 0 references indexed in Scilit: