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Intraspinal synovial cyst at the craniocervical junction
S Eustacchio1, M Trummer, F Unger
1Department of Neurosurgery, Karl-Franzens University, Graz, Austria. sandro.eustacchio@klinikum-graz.at
Zentralblatt Fur Neurochirurgie
|July 3, 2003
Summary
A rare synovial cyst compressing the brainstem was successfully treated with surgery in a 75-year-old male. This case highlights the importance of considering atlantoaxial synovial cysts in patients with neurological symptoms.
Area of Science:
- Neurosurgery
- Neuropathology
- Radiology
Background:
- Atlantoaxial synovial cysts are rare lesions causing ventral compression of the cervicomedullar cord.
- These cysts often lack specific radiographic features, leading to misdiagnosis as tumors or other spinal lesions.
Observation:
- A 75-year-old male presented with occipital pain, gait disturbance, and mild tetraparesis due to a cystic lesion near the dens.
- MRI revealed a cyst compressing the medulla oblongata, initially mimicking other pathologies.
Findings:
- Histopathological examination confirmed the lesion as a synovial cyst after subtotal removal via a minimally invasive approach.
- Postoperative recovery showed significant improvement in quadriparesis, with the patient remaining well 33 months later.
Implications:
- This case underscores the diagnostic challenges posed by atlantoaxial synovial cysts.
- Minimally invasive surgical techniques are recommended to avoid destabilization and complications.
- Early and accurate diagnosis is crucial for effective management of these rare neurological entities.