Giant anterior cervicothoracic arachnoid cyst.

Abstract

A case report with a review of the literature is presented demonstrating the imaging findings of a patient with recent onset, progressive spinal cord compression at T6 caused by a giant arachnoid cyst that was successfully treated. To present the imaging findings of a giant anterior cervicothoracic intradural arachnoid cyst using several methods before and after treatment. This case demonstrates the imaging findings of the largest described anterior cervical arachnoid cyst straddling the cervicothoracic junction. It presented with spinal cord compression in a 26-year-old diagnosed by MRI and successfully treated surgically. The patient experienced progressive left-sided sensory and motor deficits below T6. Pain and temperature sensation were decreased. Reflexes were increased in both lower extremities with clonus. Preoperative MRI was followed by laminectomy and cyst fenestration with subsequent postoperative myelogram and CT. Imaging confirmed the presence of a giant arachnoid cyst straddling the cervicothoracic junction. Postoperative imaging documented relief of spinal cord compression. Symptoms improved progressively after surgery. By the time of discharge all residual neurologic deficits had resolved. Anterior arachnoid cysts straddling the cervicothoracic junction have yet to be reported, and arachnoid cysts involving the cervical region are extremely rare. Imaging demonstrated the cyst and its response to treatment. This patient responded well to surgery and was discharged without neurologic sequelae.