Craniospinal intradural arachnoid cyst

Craniocervical junction arachnoid cyst

We report the case of a 33-year-old patient who underwent fenestration of a large symptomatic cranio-cervical junction arachnoid cyst.

Ventral Craniovertebral Junction Arachnoid Cyst in an Elderly Patient-A Case Report of a Unique Occurrence at Extremes of Age

BACKGROUND

Craniovertebral junction arachnoid cysts are uncommon. Among those reported, ventrally located arachnoid cysts at the extremes of age have been even rarer. We report a successfully managed case of a ventrally placed arachnoid cyst in an 88-year-old man using an unconventional surgical approach.

CASE DESCRIPTION

An 88-year-old man presented to us with complaints of tingling and numbness in both upper and lower limbs. He had a weak handgrip on both sides. Spinal magnetic resonance imaging (MRI) showed a non-contrast-enhancing cystic lesion over the anterior lip of the foreman magnum that had displaced the cervicomedullary junction posteriorly. The lesion was homogenously hypointense on T1-weighted MRI and hyperintense on T2-weighted MRI. The lesion was excised using a posterior approach. The cyst contents were drained, followed by complete wall excision. Complete improvement in clinical symptoms and an absence of neurological deficits were noted in the patient.

CONCLUSION

Arachnoid cysts are congenital lesions and can present at the extremes of age. Ventrally placed small symptomatic arachnoid cysts can be managed successfully through the posterior approach, especially in the elderly population.

Symptomatic Fourth Ventricle Arachnoid Cyst Extending to the Upper Border of the Dens of the Axis: A Case Report and Review of the Literature

Arachnoid cysts are congenital and non-tumorous intra-arachnoid fluid accumulations that make up about 1% of all intracranial space. occupying lesions. We report a patient with a fourth ventricle arachnoid cyst extending to the upper border of the dens of the axis. This patient progressively developed walking difficulty and stiffness in his legs together with difficulty in grasping objects with his hands within one year. The cyst was totally excised and the patient's symptoms improved in the early postoperative period, but he developed intraventricular and intracisternal air which was followed-up conservatively and resolved spontaneously.

Craniocervical arachnoid cyst in a patient with Klippel-Feil syndrome: a unique case: case report

Klippel-Feil syndrome, or brevicollis, is a complex congenital disorder caused by the improper segmentation of the cervical vertebrae. The authors present the very rare case of a patient with Klippel-Feil syndrome who presented with an intradural arachnoid cyst at the craniocervical junction. They also examine possible factors contributing to this association. A 46-year-old woman presented with complaints of progressively worsening headaches and dizziness of 18 months' duration. She also demonstrated mild bilateral upper-extremity weakness. Magnetic resonance imaging revealed fused cervical vertebrae and a dorsal intradural arachnoid cyst at the craniocervical junction, extending down to the fourth cervical level. Because of worsening myelopathy and the presence of brainstem compression, the patient underwent surgical excision of the arachnoid cyst, which was approached via a midline posterior suboccipital/upper cervical route. An endoscope was introduced through a gap between the occiput and fused upper cervical vertebrae, and the arachnoid cyst was widely fenestrated. Postoperatively, the patient has remained symptom free for more than 2 years with evidence of good radiological decompression. The authors report a unique association between craniocervical arachnoid cyst and Klippel-Feil syndrome. To their knowledge, no other cases of this association have been reported in the literature. Arachnoid cysts should be part of the differential diagnosis in the presence of worsening myelopathic symptoms or pain in patients with Klippel-Feil syndrome.

Large intradural craniospinal arachnoid cyst: A case report and review of literature

Presence of an arachnoid cyst at craniospinal junction is not very common. This is a very rare anatomic site, with only seven other cases reported in the literature. We report a case of large intradural craniospinal arachnoid cyst presenting with obstructive hydrocephalus and cranial nerve palsy. A 39-year-old male presented with 8-month history of neck pain, headache, vomiting, visual disturbances, diminished taste sensation, and numbness of face. He had bilateral papilledema on ophthalmoscopy. Magnetic resonance imaging (MRI) revealed a posterior fossa arachnoid cyst extending down to the lower border of C5 vertebra. Posterior decompression was done through C5 laminectomy. He made a full recovery and was asymptomatic at 6-month follow-up examination. The clinical features, diagnosis, and management of these rare craniospinal arachnoid cysts are discussed.

Ventrally placed craniovertebral junction arachnoid cysts in children: a report of 2 cases and literature review

BACKGROUND

Arachnoid cysts at the craniovertebral junction are uncommon, and all the reported cases had location posterior to the brain stem. We describe 2 cases of ventral arachnoid cysts among children.

CASE DESCRIPTION

Two children, in their first decades of life, presented with spastic quadriparesis without complaints of raised intracranial pressure. Magnetic resonance imaging showed large, ventrally located cystic lesions compressing the brain stem and extending from posterior fossa to the lower level of C4 vertebra. Both patients underwent surgery via midline posterior fossa approach and fenestration of cysts along with partial excision. Both patients made complete recovery and are asymptomatic in the long-term outcome.

CONCLUSION

Ventral arachnoid cysts at the craniovertebral junction present in the pediatric age group because of compression of corticospinal tracts. These patients have good long-term outcome after fenestration and partial cyst excision.

Giant anterior cervicothoracic arachnoid cyst

STUDY DESIGN

A case report with a review of the literature is presented demonstrating the imaging findings of a patient with recent onset, progressive spinal cord compression at T6 caused by a giant arachnoid cyst that was successfully treated.

OBJECTIVE

To present the imaging findings of a giant anterior cervicothoracic intradural arachnoid cyst using several methods before and after treatment.

SUMMARY OF BACKGROUND DATA

This case demonstrates the imaging findings of the largest described anterior cervical arachnoid cyst straddling the cervicothoracic junction. It presented with spinal cord compression in a 26-year-old diagnosed by MRI and successfully treated surgically.

METHODS

The patient experienced progressive left-sided sensory and motor deficits below T6. Pain and temperature sensation were decreased. Reflexes were increased in both lower extremities with clonus. Preoperative MRI was followed by laminectomy and cyst fenestration with subsequent postoperative myelogram and CT.

RESULTS

Imaging confirmed the presence of a giant arachnoid cyst straddling the cervicothoracic junction. Postoperative imaging documented relief of spinal cord compression. Symptoms improved progressively after surgery. By the time of discharge all residual neurologic deficits had resolved.

CONCLUSION

Anterior arachnoid cysts straddling the cervicothoracic junction have yet to be reported, and arachnoid cysts involving the cervical region are extremely rare. Imaging demonstrated the cyst and its response to treatment. This patient responded well to surgery and was discharged without neurologic sequelae.

Arachnoid cyst of the craniocervical junction: case report

OBJECTIVE AND IMPORTANCE

An arachnoid cyst at the craniocervical junction presenting with obstructive hydrocephalus as a result of blockage of the outflow of the fourth ventricle is described. This is a very rare anatomic site, with only five other cases described in the literature.

CLINICAL PRESENTATION

A 37-year-old woman presented with a 9-month history of severe neck pain, persistent vomiting, visual disturbances, and numbness of the nose, cheek, and lips. She had severe bilateral papilledema on ophthalmoscopy. Magnetic resonance imaging revealed a midline cystic lesion extending down to C2.

INTERVENTION

The patient underwent posterior fossa craniectomy and excision of the arachnoid cyst. She made a full recovery and was asymptomatic at follow-up examination.

CONCLUSION

The symptomatology of these rare craniocervical arachnoid cysts and their development are discussed.