What are the symptoms of dural ectasia?

Based on our findings, a “classic” picture of dural ectasia in the Marfan patient may consist of low back pain, headache, proximal leg pain, weakness and numbness above and below the knee, and genital/rectal pain.

How common is dural ectasia?

Dural ectasia is common in Marfan syndrome, occurring in 63–92% of people with the syndrome. It may also occur in Ehlers-Danlos Syndrome, neurofibromatosis type I, ankylosing spondylitis, and is associated with spondylolisthesis, vertebral fractures, scoliosis, tumors or trauma.

What is nerve root ectasia?

Dural ectasia-refers to ballooning or widening of the dural sac and is associated with herniation of nerve root sleeves. Greater than normal volume of CSF in the lumbar theca is postulated to restrict the spread of the intrathecally injected LA and is thought to be one of the main reason for spinal anaesthesia failure.

Where is the thecal sac located?

Thecal sac is the outer covering of the spinal cord. This means there are bone spurs on the back of the spinal bones, putting pressure on or affecting the front part of the outer layer of the (neck) cervical spinal cord.

Is dural ectasia painful?

Several studies and case reports indicate that dural ectasia may be present in close to 60% of patients with Marfan syndrome (2–4) and that a significant number of patients with both Marfan syndrome and dural ectasia have moderate to severe back pain (21).

Can a dural tear heal on its own?

Blood does not pass through the spinal cord naturally, and since blood flow is necessary to clot and heal wounds, the dural mater cannot heal on its own.

Why is cauda equina an emergency?

Cauda Equina Syndrome is a medical emergency because delayed decompression surgery can result in lifelong disability.

What happens if thecal sac is compressed?

If there is central stenosis and marked compression of the entire dural/thecal sac, the patient may demonstrate paralysis (e.g., cauda equina syndrome) with sphincter loss (bladder and rectal dysfunction).

What causes thecal sac compression?

Thecal Sac Compression – The spinal cord and nerves are also protected by a membrane filled with cerebral spinal fluid known as the thecal sac or dural sac. Flattening or compression of the thecal sac will occur in other conditions that cause pressure or pinching of the spinal cord, such as stenosis.

What causes dural tension?

The dura is present in the neck from the C1 to C3 cervical vertebrae. When these cervical vertebrae are unstable and wandering, they cause tension on the muscles, which are in fact trying to hold the vertebrae in place. This tension is translated to the dura via the myodural bridge.

How does Marfan progress?

In most cases, Marfan syndrome progresses as individuals grow older. In some infants, Marfan syndrome may cause severe, rapidly progressive complications during infancy, often quickly affecting multiple organ systems early in life.

What is Dural ectasia and what causes it?

Dural ectasia is one of the likely causes of incomplete or failed spinal anaesthesia. Its association with diseases like Marfans syndrome, neurofibromatosis, osteogenesis imperfecta, vertebral fracture, postopertative adhesions, trauma etc., is often overlooked as a reason for inadequate spinal anaesthesia.

How is symptomatic (painful) Dural ectasia treated?

There is no medical consensus on how to manage symptomatic (painful) dural ectasia. The majority of patients are treated conservatively with pain control medications, physiotherapy, and other physical modalities, with often incomplete control of patients’ pain. Surgical repair of the dura may provide symptomatic relief for some patients.

What are the symptoms of extensive Dural ectasia with cysts?

I have been diagnosed with extensive dural ectasia with cysts of up to 2. 5cms surrounding all sacral and L5 nerve roots. Cysts are protruding into presacral soft tissue. I have multiple vague symptoms including lower abdo pain and intermittent rectal pain. I do not have marfan’s syndrome.

How is ectasia of the dura mater diagnosed?

Dural ectasia is defined as a ballooning or outpouching of the dura with a dural volume greater than two standard deviations above the mean value in controls. It is usually identified by MRI or CT Scan, which can be used to distinguish it from tumors. Radiographs may also be used to identity secondary bone changes.