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Journal of Craniovertebral Junction and Spine
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LETTER TO EDITOR
Year : 2016  |  Volume : 7  |  Issue : 3  |  Page : 189  

Response to “syringomyelia secondary to 'occult' dorsal arachnoid webs: Report of two cases with review of literature” by Sayal et al.


Department of Neurosurgery, Baylor College of Medicine, Houston, Texas 77030, USA

Date of Web Publication16-Aug-2016

Correspondence Address:
Visish M Srinivasan
Department of Neurosurgery, Baylor College of Medicine, Houston, Texas 77030
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-8237.188416

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How to cite this article:
Srinivasan VM, Omeis I. Response to “syringomyelia secondary to 'occult' dorsal arachnoid webs: Report of two cases with review of literature” by Sayal et al. J Craniovert Jun Spine 2016;7:189

How to cite this URL:
Srinivasan VM, Omeis I. Response to “syringomyelia secondary to 'occult' dorsal arachnoid webs: Report of two cases with review of literature” by Sayal et al. J Craniovert Jun Spine [serial online] 2016 [cited 2018 May 25];7:189. Available from: http://www.jcvjs.com/text.asp?2016/7/3/189/188416

Dear Dr. Goel,

We read with interest the recent article by Sayal et al.,[1] “Syringomyelia secondary to 'occult' dorsal arachnoid webs: Report of two cases with review of literature.” They described the phenomenon of arachnoid webs being the cause of syringomyelia though the webs were not evident on magnetic resonance imaging. Their two cases are indeed compelling, and we agree with their conclusions. However, their literature review omitted our 2016 article in World Neurosurgery:[1] “Nuances in localization and surgical treatment of syringomyelia associated with fenestrated and webbed intradural spinal arachnoid cyst: A retrospective analysis.”[2]

We reported a series of seven patients with syringomyelia secondary to spinal webbed arachnoid cysts, three of which were undetected on imaging studies. While some authors differentiate between the terms, “webs,” “fenestrations,” and traditional arachnoid cysts, we believe that they are along the same spectrum and follow the same pathophysiology in causing syringomyelia.

In fact, our report cited the same reference by Paramore [3] that Sayal et al. cited, which mentioned these arachnoid “webs” as variants of traditional arachnoid cysts, and together in the same spectrum, following the same pathophysiology, to be a cause of syringomyelia.

We agree that with careful planning and complete resection of the sac to restore normal cerebrospinal fluid flow, neurosurgeons can consistently achieve good radiologic and functional outcomes in their patients.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Sayal PP, Zafar A, Carroll TA. Syringomyelia secondary to “occult” dorsal arachnoid webs: Report of two cases with review of literature. J Craniovertebr Junction Spine 2016;7:101-4.  Back to cited text no. 1
    
2.
Srinivasan VM, Fridley JS, Thomas JG, Omeis I. Nuances in localization and surgical treatment of syringomyelia associated with fenestrated and webbed intradural spinal arachnoid cyst: A retrospective analysis. World Neurosurg 2016;87:176-86.  Back to cited text no. 2
    
3.
Paramore CG. Dorsal arachnoid web with spinal cord compression: Variant of an arachnoid cyst? Report of two cases. J Neurosurg 2000;93(2 Suppl):287-90.  Back to cited text no. 3
    




 

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