Intramedullary Arachnoid Cyst of the Cervical Spine: Case Report and Literature Review

Abstract

Intramedullary arachnoid cysts of the spinal cord are extremely rare benign lesions of unclear pathogenesis. To our knowledge, only 21 cases were reported in the literature, 10 of which involved the cervical spine. We report the case of a 47-year-old female who presented with a symptomatic spinal intramedullary arachnoid cyst (SIAC). Magnetic resonance imaging scan of the cervical spine demonstrated an intramedullary arachnoid cyst at C3-C5 level. The patient had a cervical laminectomy and cysto-subarachnoid shunt with rapid and excellent clinical recovery and no recurrence at 2-year follow-up.

Intramedullary arachnoid cysts should be considered in the differential diagnosis of intramedullary cystic lesions of the spinal cord. Their pathogenesis and natural history are not well defined in the literature. However, a cysto-subarachnoid shunt can be performed with excellent long-term clinical and radiological results.

Resumo

Os cistos aracnoides intramedulares são lesões benignas extremamente raras e de origem desconhecida. Que seja do conhecimento dos autores, apenas 21 casos foram publicados, mas com apenas 10 envolvendo a coluna cervical. Os autores reportam o caso clínico de uma paciente do sexo feminino, de 47 anos de idade, com um cisto aracnoide intramedular sintomático que a ressonância magnética da coluna cervical demonstrou localizar-se no nível C3-C5. A paciente foi submetida a laminectomia cervical e derivação cisto-subaracnoide com recuperação neurológica rápida e significativa, sem recorrência após 2 anos de acompanhamento.

Os cistos aracnoides intramedulares devem ser considerados no diagnóstico diferencial das lesões císticas da medula espinhal. A patogenia, bem como a história natural, não está bem estabelecida na literatura. A derivação cisto-subaracnoide é exequível com excelentes resultados clínicos e imagiológicos.

Keywords

arachnoid cyst - intramedullary - cervical spine - case report

Palavras-chave

cisto aracnoide - intramedular - coluna cervical - relato de cas

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