Anterior Cervical Arachnoid Cyst
This 2-year-old girl was admitted to our hospital with a 2-week history of torticollis and weakness of the left upper extremity for a week. She had no history of trauma or infection of upper respiratory tract infection. Her neurological exam showed moderate paresis of the left upper extremity, all reflexes were hyperactive and plater reflex was extensor on the left side. Cervical spine X-Ray and open mouth view were regarded normal. Magnetic resonance imaging (MRI) revealed an intradural hypointense cystic mass anterior to the cord in T1 and hyperintense in T2 images resembling cerebrospinal fluid (CSF) intensity at C5-C6 level which was markedly compressing the cord (). A provisional diagnosis of intradural arachnoid cyst was made.\nWith the patient in prone position laminectomy of C5 and C6 was done. The dura was tense and on opening the cord was flattened and budged posteriorly into the dural incision. The dentate ligaments at C5-C6 level were cut on the left side revealing a translucent cystic collection anterior to the cord. The cyst was aspirated revealing CSF. Following aspiration, the cyst shrunk and the cord pulsation appeared. With gentle retraction of the cord, the cyst's capsule could be excised totally. Postoperatively, the child showed motor recovery and her neurological examination three months after surgery was normal.