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CC BY-NC-ND 4.0 · Asian J Neurosurg 2023; 18(03): 667-675
DOI: 10.1055/s-0043-1774380
Case Report

Long-Term Recurrent Intramedullary Arachnoid Cyst: Case Report and Literature Review

Hatem B. Afana 
1   Departments of Orthopaedic and Spine Surgery, King's College Hospital London, Dubai, UAE
,
Salman F.M. Kananeh 
2   Internal Medicine, Capital Health Regional Medical Center, Trenton, New Jersey, United States
,
Rajamagesh Duraisamy 
3   Department of Radiology, Medcare Orthopaedic and Spine Hospital, Dubai, UAE
,
Abdulkadir Farah 
3   Department of Radiology, Medcare Orthopaedic and Spine Hospital, Dubai, UAE
,
Nicandro Figueiredo 
1   Departments of Orthopaedic and Spine Surgery, King's College Hospital London, Dubai, UAE
4   Medical School, University of Cuiaba (UNIC), Cuiaba, MT, Brazil
5   Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
› Institutsangaben Funding None.
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Abstract

Objectives This article reports the management of a case of a 32-year-old male who presented with progressive weakness in the lower limbs and spastic paraparesis secondary to an intramedullary arachnoid cyst (IMAC). For literature review, the authors used the phrase “intramedullary arachnoid cyst” in PubMed search engine. 23 articles describing cases with IMAC were included in this review, with a total of 26 patients.

Materials and Methods We report a case with long term recurrant intramedullary arachnoid cyst and present a review on spinal intramedullary arachnoid cyst.

Result IMAC is showing bimodal incidence and trending to occur below 10 years and after 30 years. However, rarely, it should be considered in the differential diagnosis of intramedullary cystic lesions. Authors suggest doing laminoplasty or fusion for the pediatric patients to prevent kyphoscoliosis deformity in the long run, but doing early surgery to gain better outcome. Resection of the cyst wall should be done as much as possible; if it could not be achieved, then marsupialization or cysto-subarachnoid shunt should be considered. Aspiration alone or fenestration is not enough to eradicate the cyst. Long-term and prospective studies are recommended to achieve the best treatment options.

Conclusion Review supports early surgical treatment of symptomatic IMACs with resection of the cyst wall as much as possible.

Keywords

intramedullary arachnoid cyst - intramedullary lesion - spinal surgery - fenestration - marsupialization

Ethical Approval

This case report and literature review study was waived by the local Ethics Committee of the hospital and all the procedures being performed were part of the routine care.


Consent to Participate

Written informed consent was obtained from all individual participants included in the study.


Consent to Publish

The authors affirm that human research participants provided informed consent for publication of the images and data.


Availability of Data

All data are available in the database of the hospital.




Publikationsverlauf

Artikel online veröffentlicht:
13. September 2023

© 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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