Multiple Spinal Arachnoid Cysts in a Child

Abstract

FIGURE 1. (A) Midsagittal T2-weighted thoracic spine magnetic resonance imaging reveals large cystic lesions causing spinal cord compression (arrow). (B) Follow-up magnetic resonance imaging shows no evidence of residual or recurrence. This 11-year-old boy presented with progressive weakness of both legs along with numbness to the chest level of 4 months’ duration and urgency of micturition for one month. On examination, he had grade III spastic paraparesis with upgoing plantar reflexes bilaterally. Magnetic resonance imaging revealed extradural lesion resembling cerebrospinal intensity on both T1 and T2 sequences, extending from the T4 to T8 levels (Fig 1A). A D5-D8 laminectomy revealed two translucent cysts (Fig 2). Cysts could easily be separated from the dura and had very narrow pedicles that were ligated; the cysts were excised completely. Histopathology confirmed them to be arachnoid cysts. His sensory and motor function rapidly recovered and he was ambulatory with residual spasticity at the time of discharge on seventh postoperative day. Magnetic resonance imaging during the follow-up period showed no evidence of residual or recurrent cyst (Fig 1B).