Cervicothoracic Arachnoid Cyst Causing Cervical Myelopathy: A Case Report

Area of Science:

• Neurosurgery
• Radiology
• Spinal Surgery

Background:

• Intraspinal cysts, including arachnoid cysts, can occur throughout the spinal canal in both children and adults.
• Arachnoid cysts are more common in children but can present as uncommon lesions in adults, located either intradurally or extradurally.
• Intradural arachnoid cysts may be congenital or acquired due to trauma, infection, or spondylosis, and can be asymptomatic or symptomatic, especially when co-occurring with other spinal pathologies.

Observation:

• A 60-year-old male presented with nonspecific symptoms later diagnosed as an intradural extramedullary arachnoid cyst in the cervicothoracic spine.
• The cyst was initially undiagnosed due to the vague nature of his symptoms.
• Right hemiparesis prompted further investigation, revealing a posterior fluid collection compressing the spinal cord via Magnetic Resonance Imaging (MRI).

Findings:

• Magnetic Resonance Imaging (MRI) is crucial for diagnosing spinal arachnoid cysts, identifying cord compression.
• Surgical removal of the intradural extramedullary arachnoid cyst was successfully performed.
• Post-operative recovery showed reversal of spinal cord compression and resolution of the patient's symptoms.

Implications:

• This case highlights the importance of considering intraspinal arachnoid cysts in the differential diagnosis of adult spinal pathologies, even with nonspecific symptoms.
• Timely radiological diagnosis and surgical intervention are key to successful outcomes.
• Effective surgical management can lead to complete symptom reversal and improved neurological function.