Spinal arachnoid cyst
Intradural arachnoid cysts may be congenital or may follow infection or trauma.
Usually asymptomatic, even if large.
When indicated, treatment options include:
1. percutaneous procedures: may be done under MRI 1)
. or CT
guidance. CT guidance usually requires use of intrathecal contrast to delineate the cyst
A. needle aspiration.
B. needle fenestration.
2. open surgical resection or fenestration
Takahashi et al. describe the case of a high cervical, intradural extramedullary cyst located anterior to the spinal cord in a 13-year-old boy. The lesion was fenestrated percutaneously by using real-time magnetic resonance (MR) imaging guidance and a local anesthetic agent. The patient’s symptom, severe exercise-induced headache, immediately resolved after treatment. Nine months later, complete disappearance of the cyst was confirmed on MR imaging and computerized tomography myelography. Magnetic resonance imageing-guided fenestration can be considered a minimally invasive option for intradural cystic lesions 2)