Open meningocele associated with a cervical spinal arachnoid cyst and Arnold Chiari malformation type II, a case report

Abstract

Introduction: Spina bifida is a congenital malformation involving the vertebral spine with different presentations ranging from occult defects to large cutaneous defects exposing tissue and nerves. Case report: Here we describe a patient who had open spina bifida with exposure of the nerve roots, which seemed to be functional on physical examination. A few days after surgery for the closure of the lumbosacral defect, the patient presented with severe respiratory distress and quadriparesis. Magnetic resonance imaging showed a cervical arachnoid cyst and Arnold Chiari type II malformation requiring a second surgical procedure consisting of decompression of the bones and ligaments at the craniospinal junction and microsurgical fenestration of the spinal arachnoid cyst. Discussion: To our knowledge, spinal arachnoid cysts are a rare entity in pediatric patients. On the other hand, spinal dysraphism, of which myelomeningocele is the most frequent congenital form, is common. In a literature search, no previous reports were found of cases similar to ours with open spinal dysraphism with these specific anatomical characteristics associated with an arachnoid cyst in the cervical spine and Arnold Chiari malformation. Conclusion: Spinal dysraphism includes different complex disorders. Full spinal magnetic resonance imaging is recommended for the early detection of associated conditions.

Keywords

• myelomeningocele
• arnold-chiari malformation
• arachnoid cyst
• open spina bifida