Long-Term Recurrent Intramedullary Arachnoid Cyst: Case Report and Literature Review

Area of Science:

• Neurosurgery
• Spinal Surgery
• Neurology

Background:

• Intramedullary arachnoid cysts (IMACs) are rare cystic lesions within the spinal cord.
• They can cause progressive neurological deficits, including weakness and spasticity.

Observation:

• A case of a 32-year-old male with IMAC presenting with lower limb weakness and spastic paraparesis is reported.
• A literature review identified 23 articles with 26 patients diagnosed with IMACs.

Findings:

• IMACs exhibit a bimodal incidence, occurring predominantly in children under 10 and adults over 30.
• Complete resection of the cyst wall is the preferred surgical approach.
• Marsupialization or cysto-subarachnoid shunt are alternatives if complete resection is not feasible.
• Aspiration or fenestration alone is insufficient for cyst eradication.

Implications:

• Early surgical treatment of symptomatic IMACs is crucial for better patient outcomes.
• Surgical strategies should aim for maximal cyst wall resection.
• Further long-term studies are recommended to optimize treatment protocols for IMACs.