Arachnoid cyst masquerading as obstetric brachial plexus palsy

Case report

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  • Department of Neurosurgery, Madurai Medical College, Madurai, India
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Obstetric brachial plexus palsy is not uncommon. However, lesions masquerading as obstetric brachial plexus palsy are rare. A child with a cervicothoracic arachnoid cyst masquerading as obstetric brachial plexus palsy is presented, and the relevant literature is reviewed. A girl born by vaginal delivery at full term without any antecedent risk factors for obstetric brachial plexus palsy was noted to have decreased movements of the right upper extremity. After 7 months, there was no improvement. An MRI scan was obtained, which revealed a cervicothoracic spinal extradural arachnoid cyst. During surgery, the cyst was found to communicate with the dura at the axilla of the C-7 nerve root. The cyst was excised in toto. Six months later, there was improvement in the infant's neurological status. This case illustrates that spinal arachnoid cysts should be entertained in the differential diagnosis when a child presents with obstetric brachial plexus palsy without known antecedent risk factors for obstetric palsy.

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Contributor Notes

Address correspondence to: Natarajan Muthukumar, M.Ch., Muruganagam, 138 Anna Nagar, Madurai, 625020 India. email: drnmuthukumar@yahoo.com.

Please include this information when citing this paper: published online June 8, 2012; DOI: 10.3171/2012.3.PEDS11212.

  • 1

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  • 2

    Malessy MJA, , Pondaag W, & van Dijk JG: Electromyography, nerve action potential, and compound motor action potentials in obstetric brachial plexus lesions: validation in the absence of a “gold standard”. Neurosurgery 65:4 Suppl A153A159, 2009

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  • 3

    Miravet E, , Sinisterra S, , Birchansky S, , Papazian O, , Tuite G, & Grossman JA, : Cervicothoracic extradural arachnoid cyst: possible association with obstetric brachial plexus palsy. J Child Neurol 17:770772, 2002

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  • 4

    Ruchelsman DE, , Pettrone S, , Price AE, & Grossman JAI: Brachial plexus birth palsy: an overview of early treatment considerations. Bull NYU Hosp Jt Dis 67:8389, 2009

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