Neurenteric cyst at the craniovertebral junction: A report of two cases
A 36-year-old lady presented with complaints of intermittent right-sided headache of 2 years duration with a 20-day history of diplopia, mild deviation of angle of the mouth to the left, and decreased hearing in the right ear. Neurological examination revealed right 6th, 7th, and 8th nerve paresis with cerebellar ataxia. Audiological investigation revealed a right sensorineural hearing loss. An MRI of the brain showed an extra-axial lesion in the right cerebellomedullary cistern, measuring 4 × 3 × 2.5 cm, extending from lower clivus up to the rim of foramen magnum []. The various possibilities considered were NC, epidermoid or dermoid cyst.\nThe patient was placed in the left lateral position, and a right far-lateral approach was taken. Intraoperatively, a thin-walled cyst was seen located ventral to the lower cranial nerves and extending from the 7th to the 8th complex up to the foramen magnum and extending into the jugular foramen. The cyst was decompressed by puncturing the cyst wall and aspirating its thick yellow contents. The cyst wall was gently separated and excised under Nerve Integrity Monitoring (NIM) []. The surgical cavity was irrigated with steroid impregnated saline. The postoperative period was uneventful.\nThe HPE was suggestive of NC with cyst wall lined with pseudostratified ciliated columnar epithelium [].