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.

[1]  S. Gupta,et al.  Ventrally placed craniovertebral junction arachnoid cysts in children: a report of 2 cases and literature review. , 2007, Surgical neurology.

[2]  K. Desai,et al.  Extradural arachnoid cysts: a study of seven cases , 2004, British journal of neurosurgery.

[3]  B. Radotra,et al.  Craniospinal intradural arachnoid cyst. , 1992, Postgraduate medical journal.

[4]  C. Raffel,et al.  To shunt or to fenestrate: which is the best surgical treatment for arachnoid cysts in pediatric patients? , 1988, Neurosurgery.

[5]  M. Giulioni,et al.  Long-term results of surgically treated congenital intradural spinal arachnoid cysts. , 1987, Journal of neurosurgery.

[6]  T. Naidich,et al.  Intracranial arachnoid cysts. , 1985, Pediatric neuroscience.

[7]  R. Chan,et al.  Symptomatic anterior spinal arachnoid diverticulum. , 1985, Neurosurgery.

[8]  J. Palmer Spinal arachnoid cysts. Report of six cases. , 1974, Journal of neurosurgery.

[9]  J. Little,et al.  Infratentorial arachnoid cysts. , 1973, Journal of neurosurgery.

[10]  K. Faulder,et al.  Spinal arachnoid cysts. , 1968, Australasian radiology.

[11]  R. D. Reddy Intracranial arachnoid cysts. , 2013, Neurology India.

[12]  J. Stevens,et al.  Percutaneous insertion of the spinal end of a cysto-peritoneal shunt as definitive treatment to relieve cord compression from a spinal arachnoid cyst , 2004, Neuroradiology.

[13]  S. Rengachary,et al.  Ultrastructure and pathogenesis of intracranial arachnoid cysts. , 1981, Journal of neuropathology and experimental neurology.

[14]  W. Leschey Posterior fossa arachnoid cysts. , 1979, The Journal of the Maine Medical Association.