Spinal intradural arachnoid cyst with spinal dysraphism

Spinal arachnoid cysts are relatively uncommon, they may be either intra- or extradural, among them the intradural spinal arachnoid cysts are less common. The authors report a patient with this rare lesion, in whom an anterior spinal intradural arachnoid cyst was associated with thoracic split cord malformation type I (diastematomyelia) and tethering of cord. The cyst was located anterior to the thoracic spinal cord. Our patient was an 8-year-old child who presented with progressive paraparesia. The presence of an intradural anterior arachnoid cyst was detected on magnetic resonance imaging. Surgical treatment was performed on all three lesions during the same sitting. Complete surgical excision of the cyst was the best choice of treatment with simultaneous treatment of the associated anomalies. The most important advantage of handling all three distinct lesions in one sitting, is that he was operated during a single exposure anaesthesia, which remains an important consideration in a child. The surgical treatment carried out and review of pertinent literature is being presented here. (J Pediatr Neurol 2004; 2(4): 235-239).