SYMPTOMATIC SPINAL INTRADURAL ARACHNOID CYST DEVELOPMENT AFTER LUMBARMYELOGRAPHY - CASE-REPORT AND REVIEW OF THE LITERATURE

Study Design. This case report describes the unique occurrence of acqu ired intradural spinal arachnoid cyst after lumbar puncture, which was proven radiographically and surgically. Objectives. To review and exp lore complications Of lumbar puncture in the context of subsequent cys t development and to review the incidence, presentation, pathogenesis, and management of spinal intradural arachnoid cysts. Summary of Backg round Data. The etiology of the spinal intradural arachnoid cyst remai ns obscure; some such cysts are ascribed anecdotally to previous traum a or arachnoiditis, whereas the majority are idiopathic and assumed by many authors to congenital. Methods. A 20-year-old woman with back an d leg pain underwent lumbar myelography that yielded normal results wi th no evidence of arachnoid cyst at that time. With 5 months, clinical symptoms of cauda equina compression and an S1 radiculopathy develope d. Subsequent myelography and magnetic resonance imaging revealed a lu mbar spinal arachnoid cyst. There was no history of intervening trauma or arachnoiditis. The lumbar puncture was thought to be the cause of the arachnoid cyst. Results. A laminectomy was performed with complete excision of the arachnoid cyst. The patient had an unremarkable posto perative course with excellent relief of her symptoms. Conclusions. Th is case provides supporting evidence for the traumatic etiology of spi nal intradural arachnoid cyst. The development of an intradural spinal arachnoid cyst should be included as a possible implication of lumbar puncture.