THORACIC INTRADURAL EXTRAMEDULLAR ARACHNOID CYST IN AN ADULT: CASE REPORT AND REVIEW OF THE LITERATURE

Özet

Spinal intradural arachnoid cysts are rare and primarily benign lesions. These cysts are typically located posterior to the spinal cord in the middle to lower thoracic spinal legion. They occur more frequently during adolescence or in early adult life. The true mechanism of arachnoid cysts development is not yet known. Possible mechanisms proposed include congenital, inflammatory arachnoidal adhesions, and, arachnoiditis secondary to subarachnoid haemorrhage, local anaesthetics and contrast agents, injury of the spinal column. Depending on the location, size, and mechanism of origin, the clinical course varies between asymptomatic, incidentally-diagnosed cases to severe myelopathy and/or radiculopathy. The final diagnosis is based on combined imaging, intra-operative, and histopathological findings. In the differential diagnosis cystic tumours, ependymal cysts, neurenteric cysts, teratogenic cysts and epithelial cysts should be considered. Surgical approach is usually indicated for symptomatic patients or progression in size through excision in the epidural space/fenestration in the intradural space. The basic surgical principle is the removal of spinal compression with cyst excision. Shunts may be considered in recurrent cysts. Because of its rare diagnosis mostly case reports have been reported in the literature. Thus, we report an adult patient with thoracic intradural extramedullary arachnoid cyst with a complaint of dorsalgia who responded well to Gabapentin treatment along with literature review.