Spinal arachnoid cyst related to a nonaneurysmal perimesencephalic subarachnoid hemorrhage: case report.

Abstract

We report the first case of a delayed symptomatic spinal arachnoid cyst related to a nonaneurysmal perimesencephalic hemorrhage. We review the literature concerning posthemorrhagic spinal arachnoid cysts. A 64-year-old woman presented with progressive spinal cord compression symptoms 10 months after a nonaneurysmal perimesencephalic hemorrhage. Magnetic resonance imaging of the spine disclosed a dorsal and intradural cystic lesion producing posterior spinal cord compression. A thoracic laminectomy allowed complete resection of the cyst. Surgical and histological findings disclosed an intradural arachnoid cyst. On postoperative follow-up, spinal magnetic resonance imaging confirmed satisfactory decompression of the spinal cord. Because of extensive arachnoiditis, the patient experienced only partial recovery from neurological deficits. This extremely rare complication should be kept in mind when delayed lower-limb neurological deficits appear after subarachnoid hemorrhage, even in a perimesencephalic form.