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A Journal on Neurosurgery

Indexed/Abstracted in: e-psyche, EMBASE, PubMed/MEDLINE, Neuroscience Citation Index, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,651

Frequency: Bi-Monthly

ISSN 0390-5616

Online ISSN 1827-1855


Journal of Neurosurgical Sciences 2000 September;44(3):165-9


Lumbosacral ­dural ecta­sia in ­type 1 neu­ro­fib­ro­mat­o­sis. Report of two cas­es

Schonauer C., Tessitore E., Frascadore L., Parlato C., Moraci A.

Institure of Neurosurgery, Service of Traumatologic Neurosurgery, Second University of Naples, Naples, Italy

Dural ecta­sia ­denotes cir­cum­fe­ren­tial expan­sion or dil­a­ta­tion of the ­dural sac, and has ­been fre­quent­ly report­ed in asso­ci­a­tion ­with ­type 1 neurofibromatosis (NF1). The path­o­gen­e­sis has not ­been ­defined, but its cor­re­la­tion ­with NF1 ­infers a con­gen­i­tal mal­for­ma­tive hypoth­e­sis. The neu­ral ele­ments in the dilat­ed ­sleeve typ­i­cal­ly are not ­enlarged or abnor­mal, nev­er­the­less the ­enlarged ­area con­tain an ­increased ­amount of cere­bro­spi­nal ­fluid. The ­dura in the ­area of ecta­sia is extreme­ly ­thin and frag­ile, and ­erodes the sur­round­ing ­bony struc­tures destab­il­is­ing the ­spine and per­mit­ting spec­tac­u­lar spi­nal defor­mities. We ­present two cas­es ­with lum­bos­a­cral ­dural ecta­sia, enlarge­ment of the inter­ver­te­bral for­a­mi­na and pos­te­ri­or scal­lop­ing of ver­te­bral bod­ies. Neurological exam­ina­tion ­showed sciat­ic ­nerve irri­ta­tion. As the eti­ol­o­gy of ­this mal­for­ma­tion ­remains uncer­tain and dys­plas­tic chang­es of the ­spine may be intrin­sic or sec­on­dary con­tro­ver­sies ­remain ­about opti­mum treat­ment. We con­clude ­that ­patients affect­ed by NF-1 ­require an accu­rate neu­ro­ra­dio­log­i­cal ­study of the ­whole ­spine in ­order to ­detect pos­sible ­dural and spi­nal anom­a­lies. Surgical treat­ment is indi­cat­ed ­only in ­patients ­with pro­gres­sive neu­ro­log­i­cal dete­ri­ora­tion. The ­thin ­dural sac pre­dis­pos­es to a ­high mor­bid­ity if sur­gery is under­tak­en.

language: English


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