Cervicothoracic Arachnoid Cyst Causing Cervical Myelopathy: A Case Report
Zahir Kizilay1, Ali Yilmaz1, Ayca Ozkul2
1Adnan Menderes University, Medical Faculty, Neurosurgery, Aytepe Campus, Aydin 09100, Turkey.
Insights
Intraspinal arachnoid cysts can cause spinal cord compression, even in adults. Surgical removal of these cysts effectively reverses neurological symptoms.
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.
Abstract:
Several types of intraspinal cyst develop within the spinal canal from the craniovertebral junction to the sacrum. These lesions occur in both children and adults. Arachnoid cysts are one of them and are more frequent in the paediatric population, being a relatively uncommon lesion in adults. The arachnoid cyst may be located intradurally or extradurally. The intradural type may be congenital or from spinal trauma, infection or spondylosis. Although intradural arachnoid cysts are often asymptomatic, they may give early symptoms when they exist with synchronous pathologies constricting the spinal canal gradually as in cervical spondylosis. In this report, a 60-year-old man with an arachnoid cyst of the cervicothoracic spine is presented. His cyst remained undiagnosed because of the nonspecific nature of the symptoms. It was only when he developed right hemiparesis that a posterior fluid collection compressing the spinal cord was found in Magnetic resonance imaginig. An intradural extramedullary cyst was removed with successful surgery and cord compression and symptoms were reversed. We discuss radiological diagnosis and surgical treatment of an arachnoid cyst in this report.
