Posttraumatic Arachnoid Cyst in the Thoracic Spine with Medullary Compression: Case Report

Abstract

Arachnoid cysts are rare; they can occur at all levels of the dural sac, and can have a congenital, traumatic, iatrogenic or inflammatory origin. In the present article, we report a patient presenting a compressive thoracic myelopathy due to an unusual intradural arachnoid cyst with posttraumatic manifestation and its resolution, in addition to a literature review on the subject. These cysts mainly occur at the thoracic spine, followed by the lumbar, lumbosacral and thoracolumbar spines. Traumatic cysts are caused by an injury to the inner dural layer. These lesions produce neurological deficits through a mass effect on the spinal cord. Concomitant compressive myelopathy is even rarer. In case of myelopathy, cyst resection or drainage is the treatment of choice, and it must be performed immediately. Although rare, arachnoid cysts can be a complication of spine fractures; as such, orthopedists and neurosurgeons, who commonly see these injuries, must be prepared for this unusual situation.

Keywords

arachnoid cysts - spinal cord injuries - spinal cord compression

• Referências

• 1 Yanni DS, Mammis A, Thaker NG, Goldstein IM. Traumatic fracture of thin pedicles secondary to extradural meningeal cyst. J Surg Tech Case Rep 2011; 3 (01) 40-43
• 2 Shibata T, Nakamura H, Yamano Y. Intradural arachnoid cyst associated with thoracic spinal compression fracture: 7-year follow up after surgery. Spinal Cord 2001; 39 (11) 599-601
• 3 Hernández-León O, Pérez-Nogueira FR, Corrales N. [Postraumatic epidural arachnoid spinal cyst: case report]. Neurocirugia (Astur) 2011; 22 (03) 267-270
• 4 Vaccaro AR, Oner C, Kepler CK. et al. AOSpine Spinal Cord Injury & Trauma Knowledge Forum. AOSpine thoracolumbar spine injury classification system: fracture description, neurological status, and key modifiers. Spine 2013; 38 (23) 2028-2037
• 5 Chen HJ, Chen L. Traumatic interdural arachnoid cyst in the upper cervical spine. Case report. J Neurosurg 1996; 85 (02) 351-353
• 6 Alvisi C, Cerisoli M, Giulioni M, Guerra L. Long-term results of surgically treated congenital intradural spinal arachnoid cysts. J Neurosurg 1987; 67 (03) 333-335
• 7 Levin TL, Zimmerman RD, Lieberman H. Intradural spinal arachnoid cyst. Case report. Clin Imaging 1990; 14 (03) 245-247
• 8 Kong WK, Cho KT, Hong SK. Spinal extradural arachnoid cyst: a case report. Korean J Spine 2013; 10 (01) 32-34
• 9 Wang MY, Levi AD, Green BA. Intradural spinal arachnoid cysts in adults. Surg Neurol 2003; 60 (01) 49-55 , discussion 55–56
• 10 Kendall BE, Valentine AR, Keis B. Spinal arachnoid cysts: clinical and radiological correlation with prognosis. Neuroradiology 1982; 22 (05) 225-234