Anterior Cervical Arachnoid Cyst
This 17-year-old male was referred with dull moderate neck pain followed with progressive weakness of the right upper extremity of one month duration followed by gait disturbances in recent days. On clinical survey, he was found to have quadriparesis most prominent in the right upper extremity. Cervical MRI disclosed a ventrally located intradural cystic lesion with apparent cord compression at C2-C3 level ().\nWith the patient in prone position, a cervical midline incision was made at the appropriate levels. En-block laminotomy of C2 and C3, incising the corresponding laminas bilaterally with the aid of high speed drill was done. The dura seemed under considerable pressure. The techal sac was open in the midline. This revealed a splayed cord under considerable pressure from the anterior. After sectioning dentate ligament on the right side and mild retraction of the cord, a cystic mass with transparent wall became visible. The wall of the cyst was minimally incised disclosing clear content compatible with CSF. Subsequently, the cyst was widely fenestrated into the subarachnoid space with partial removal of the capsule (). The cord was decompressed and returned to its normal position with good pulsation. Later, after dural closure, two level laminoplasty with application of mini plates was done bilaterally (, ). The patient made uneventful recovery and post operative cervical MRI showed resolution of the arachnoid cyst (). He returned to his previous activities within six months.