Symptomatic spinal arachnoid cysts: report of two cases with review of the literature.

Abstract

Two unusual cases of intradural extramedullary noncommunicating arachnoid cysts are presented, with a review of literature. To assess surgical excision results in the reversal of symptoms and neurologic deficits. Most patients harboring arachnoid cysts are asymptomatic. Noncommunicating intradural extramedullary arachnoid cysts are more rare than communicating intradural extramedullary cysts. Noncommunicating intradural extramedullary arachnoid cysts are a very rare cause of spinal cord compression. Rarely, these cysts can present with bizarre symptoms, such as angina. The first case, a 75-year-old woman, presented with progressive paraparesis. The second case, a 40-year-old man, presented with signs and symptoms of angina, with mild spasticity in the lower limbs. In both cases, magnetic resonance imaging revealed compression of the spinal cord as the etiology of presentation. The first patient is the second oldest patient in the literature with an idiopathic spinal arachnoid cyst. The second case has an unusual presentation that has not previously been reported in the literature. Both cases underwent surgical excision of the arachnoid cyst, with resolution of symptoms and reversal of neurologic deficit. Our experience indicates that complete recovery from an arachnoid cyst is possible after surgical excision, even when symptoms are present for a long duration, even in the elderly.