Intradural extramedullary arachnoid cyst - cervical spine

Case contributed by Dr Mohammad A. ElBeialy

Presentation

Neck pain with bilateral upper limbs parasthesia.

Patient Data

Age: 55 Years
Gender: Female
  • a lobulated creeping right-sided intra-spinal intradural extra-medullary predominantly cystic lesion is seen, extending from C2/C3 till’ C7/D1 level. 
    • it shows heterogenous; predominantly hypointense T1 and hyperintense T2 and GRE signal intensity. 
    • the lesion shows facilitated diffusion with no fluid restriction (low signal on DWI and high signal on ADC ). 
    • the lesion shows no evident post-contrast enhancement. 
    • the lesion measures about 5.5 X 2.5 X 1.3 cm in its main CC, and axial diameters respectively. The lesion is seen compressing and displacing the spinal cord posteriorly and to the left side.
  • normal cervical cord and cervico-medullary junction with no cord syrinx or abnormal signal intensity.
  • fairly good vertebral alignment.
  • no posterior disc lesion.
  • no marrow signal abnormality.
  • no para-spinal masses.

Conclusion

A lobulated and creeping intra-spinal intradural extra-medullary non-enhancing cystic lesion, mostly arachnoid rather than epidermoid cyst.

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Case Information

rID: 23442
Case created: 15th Jun 2013
Last edited: 25th Feb 2016
Inclusion in quiz mode: Included

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