Thoracic intradural arachnoid cyst: when to operate? About a series of cases

Abstract

Introdution: Historically, the first arachnoid cyst was detected by Schlesinger in 1893, and the first report was by Spiller in 1903. Arachnoid cysts (AC) are benign tumors that develop in the cerebrospinal axis of the arachnoid membrane being common in people in the second decade of life, and predominantly in the middle and lower thoracic region (65%), in the lumbar and lumbosacral spine (13%), thoracolumbar (12%), sacral (7%) and cervical (3%). The intramedullary location of the AC is rare, with only a few cases reported in the literature. Objective: To describe a series of 2 cases of intradural thoracic AC, explaining its treatment with greater focus. Materials and methods: Description of 2 cases of patients with thoracic intradural AC and literature review. Discussion/Results: Most AC are found incidentally, are therefore asymptomatic, and remain constant in size, leading many physicians to recommend conservative treatment and periodic monitoring. The standard treatment for thoracic intradural AC that presents with symptoms, on the other hand, involves surgical exploration and relief of neural tissue compression, preferably before causing significant neurological deficits, as there is a greater chance of a satisfactory postoperative result. Final Considerations: Thoracic intradural AC, despite being rare, when symptomatic, need surgical treatment and should not be delayed due to the risk of progressive neurological motor deficit.