2025 American Academy of Neurology Abstract Website

Objective:

To emphasize the importance of timely intervention for treating thoracic arachnoid cysts to achieve immediate relief of neurological deficits.

Background:

Arachnoid cyst is a rare cause of spinal cord compression that can lead to neurological symptoms, including pain and stiffness in the neck and back, as well as numbness, cramping, and weakness in the extremities. It is important to keep it in the differential diagnosis alongside spinal abscess, spinal tumors, rheumatoid arthritis, and back injuries.

Design/Methods:

A case study.

Results:

A 47-year-old female presented with numbness and a prickly, cold sensation in her extremities, along with head tightness that had persisted for the past year. She reported difficulty reading emails due to short-term memory issues, as well as constant neck and low back pain that worsened with walking. Additionally, she experienced sharp, electric sensations radiating through her spine and extremities, along with balance problems and bowel and bladder issues over the same period. Despite being treated with gabapentin and medical marijuana, and using heat for relief, she had seen no improvement.

An MRI of the thoracic spine revealed a thoracic cyst (scalpel sign) at the T9-T10 region of the spinal cord, which caused canal narrowing and anterior displacement of the spinal cord.

The patient subsequently underwent a T9-T10 laminectomy with durotomy and fenestration of the arachnoid cyst. Postoperatively, she did well overall, denying any fever, nausea, vomiting, diarrhea, or shortness of breath. She had no bowel or bladder dysfunction and reported no falls, seizures, blurry vision, or headaches. She also denied any complaints related to her incision.

Conclusions:

Back pain, numbness, tingling, weakness, and temperature variations in the body and extremities are frequently associated with spinal cord compression. It is crucial to include arachnoid cysts in the differential diagnosis, despite their rarity.