Rafi A Ghori, Aftab A Qureshi, Manzoor A Memon, Pervaiz Asghar.
Arachnoid Cyst presenting as Paraparesis in a Young Girl.
Biomedica Jan ;14:137-9.

A girl aged 26 years was admitted to a medical ward with history of weakness in lower limbs for last 2 months. Her weakness was initially mid at the onset of disease but it gradually increased in severity. One week prior to coming to hospital, she was unable to put weight on her lower limbs and became bed ridden. There was a history of reduced sensation in both lower limbs, along with urinary and faecal incontinence.

On examination, she was a young girl without anemia, jaundice or cyanosis, lying in bed. Systemic examination was otherwise normal except she had signs of upper motor neurone lesions in lower limbs with decrease power, increase tone and planters upwards, all modalities of sensation were impaired upto T2 level. She was incontinent for urine and faeces. She has no cerebellar signs and her fundi were normal. MRI of dorsal spine showed evidence of mass in the posterior epidural space extending from the level D-1 to D-10. It measures 1.5cm x 8.0 cm. It was displacing the spinal cord the spinal cord anteriorly. Other investigations including blood counts, urine analysis, chest and dorsal spine radiography, ultrasound of abdomen and pelvis were within normal limits.

Patient was diagnosed as a case of Arachnoid Cyst for which operative treatment was carried out, laminectomy was done from D2-D5. Dura was found tense and bluish. On opening, CSF came with pressure and dural sac immediately became pulsatile. Post-operatively patient had reduced heaviness in both legs on following days. Within a few days she regained power. After 7-10 days she was able to walk but with a slight incoordinated gait. Her bladder and bowel functions became normal.

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