Intramedullary spinal neurenteric cyst with fluid-fluid level

Case report

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Spinal neurenteric cysts are rare intradural extramedullary lesions of the spine, commonly located in the cervical and thoracic regions. The majority localize ventral to the spinal cord and are associated with other vertebral anomalies. Here, the authors report a rare case of a 3-year-old boy presenting with a 1-week history of meningismus followed by rapid-onset (over a few hours) paraplegia. Magnetic resonance imaging revealed an intramedullary cystic lesion with a fluid-fluid level in the cervicothoracic region of the spinal cord without associated bony or soft tissue abnormalities. To the best of the authors' knowledge, such clinical and radiological presentation of a spinal neurenteric cyst has never been reported. A brief review of the pertinent literature is presented, and the possible pathophysiology of such a presentation is also discussed.

Article Information

Address correspondence to: Amit Mahore, M.Ch., Department of Neurosurgery, King Edward Memorial Hospital, Seth G.S. Medical College, Acharya Donde Marg, Parel, Mumbai 400 012, India. email: amit2mahore@yahoo.co.in.

Please include this information when citing this paper: DOI: 10.3171/2012.1.PEDS11469.

© AANS, except where prohibited by US copyright law.

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Figures

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    Sagittal T1-weighted MR image of the spine showing a welldemarcated oval intramedullary cystic lesion. A fluid-fluid level is noted with isodense supernatant fluid and brightly hyperdense infranatant.

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    Sagittal T2-weighted MR image showing a well-defined intramedullary cystic lesion with surrounding cord edema and associated arachnoiditis. A fluid-fluid level is visible.

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    Axial T1-weighted MR image showing an intramedullary cystic lesion with a fluid-fluid level.

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    Photomicrograph showing a cyst lined by pseudostratified, ciliated, columnar epithelium resting on a fibrocollagenous wall. At the periphery, neural parenchyma with lymphocytic infiltrate is apparent. H & E, original magnification × 400.

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