Intraspinal Degenerative Cyst Causing Compression Of Cervicomedullary Junction

Intraspinal degenerative cysts in the cervical region are rare disorders that may cause myelopathy or radiculopathy. Most of the intraspinal degenerative cysts reported are extradural cysts. This case report includes the neuroimaging, intraoperative, pathologic, and postoperative findings obtained in a patient with a degenerative intradural cyst at the craniovertebral (CV) junction.

We report a patient presenting with progressive spastic quadriparesis resulting from compressive myelopathy due to intradural degenerative cyst at the CV junction. Preoperative magnetic resonance imaging showed the intradural cyst at the cervicomedullary junction with degenerative changes causing myelopathy. We performed decompression of the CV junction, and histopathology of the cyst revealed degenerative cyst. Postoperatively the symptoms were relieved with no apparent complication. Intraspinal degenerative cysts causing compressive myelopathy are rare. To the best of our knowledge, this is the first case of intradural degenerative cyst at the CV junction.

In this case report, we demonstrated the clinical, imaging, intraoperative, and pathologic features of a degenerative intraspinal cyst at the CV junction that was intradural in location. Compression of the spinal cord resulted in a gradually progressive myelopathy that showed remarkable improvement immediately after decompression by cystectomy.