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Unusual association of cervical arachnoid cyst and idiopathic intracranial hypertension

Shirin H. Alokayli, Sarah A. Maghrabi, Fawaz S. Almotairi and Sherif M. Elwatidy
Neurosciences Journal October 2024, 29 (4) 284-287; DOI: https://doi.org/10.17712/nsj.2024.4.20240005

Article Figures & Data

Figures

  • Figure 1
    Figure 1

    - Preoperative MRI scan T2series, sagittal (A) and axial (B) images showing the arachnoid cyst (white arrows) occupying the left half of the body of C5 and expanding the left C5-6 intervertebral foramen.

  • Figure 2
    Figure 2

    - CT scan after C5 corpectomy and C4-6 fusion and fixation with titanium plate and screws (red arrow), sagittal (A) and axial (B) images showing bony changes (yellow arrow) involving the body, pedicle and lamina of C5 vertebra

  • Figure 3
    Figure 3

    - MRI scan T2 series, sagittal A) and axial (B) images showing enlargement of the residual AC (white arrow) after ligation of the LP shunt.

Tables

  • Table 1

    - Timeline for events and follow-ups of the patient.

    DatesRelevant past medical history and interventions
    2011A 71-year-old male patient, with a medical history including hypertension, dyslipidemia, hypothyroidism, and coronary stent placement a decade ago, in addition to a prior left donor nephrectomy.
    DatesSummaries from initial and follow-up visits/eventsDiagnostic testingInterventions
    2011Initial visit: Bilateral shoulder and arm pain.Clinical and radiological assessments reveal cervical arachnoid cystAnterior C5 corpectomy, cyst excision, and C4–C6 vertebrae fusion
    2011Postoperative eventMRI: shows CSF leakageLumboperitoneal (LP) shunt insertion to manage CSF leakage
    2019Follow-up visit: Recurrence of symptoms (bilateral shoulder and arm pain for 3 months)MRI: Showed cyst progressionRevision of LP shunt due to elevated CSF opening pressures (>25 cm)
    2019Postoperative: Improvement in symptomsPostoperative imaging (MRI): Indicated cyst regressionFollow up
    2022Follow-up visit: Recurrent symptoms (headache, dizziness, altered consciousness)MRI and CT scans: Confirmed subdural collections and intracranial hypotension due to LP overshuntingLP shunt Clamping
    2023Follow-up visit: Persistent symptoms (shoulder and arm pain, headache, dizziness)MRI: cyst progressionInsertion of a right frontal ventriculoperitoneal (VP) shunt with a medium-pressure valve under laparoscopic guidance
    2023Follow-up visit: Significant improvement in symptoms (resolution of headache, dizziness)Follow-up imaging: Documented regression of the cervical cystFollow up
    2023Follow-up visit: Stability in neurological functionN/AConfirmed success of VP shunt intervention
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