Spinal extradural arachnoid cyst presenting with squatting-induced lower extremity symptoms: A case report.
- 1Department of Neurosurgery, Toho University Ohashi Medical Center, Tokyo, Japan.
- 2Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan.
Abstract
Background
Spinal extradural arachnoid cysts (SEACs) may cause progressive myelopathic or cauda equina symptoms but are often asymptomatic and incidentally detected. Determining symptom causality is challenging when radiological compression is mild.Case description
A 73-year-old female presented with bilateral lower-extremity weakness induced by squatting. The neurological examination was unremarkable except for decreased lower-extremity reflexes. The magnetic resonance imaging revealed a SEAC at the T11-L1 level causing minimal neural compression. Myelography and cystography failed to identify a dural defect. Following direct cyst puncture, her squatting-induced symptoms resolved. She was, therefore, diagnosed with a symptomatic SEAC and successfully underwent cyst excision with dural repair. Postoperatively, her symptoms completely resolved within 1 week, and she was discharged after an uneventful postoperative course. At the 3-month follow-up, she remained symptom-free.Conclusion
In certain cases, symptom resolution after direct spinal cyst puncture may help determine the clinical significance of SEACs. Posture-induced symptoms, such as those triggered by squatting, may provide important diagnostic clues as to how to treat symptomatic SEACs.
Related
- Intraoperative demonstration of a check-valve mechanism in a spinal extradural arachnoid cyst with nerve root incarceration
- Pre-operative identification of a dural defect using T2*-reversed magnetic resonance imaging in a spinal extradural arachnoid cyst: A case report.
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BibTeX
@article{sato2026spinal,
title = {{Spinal extradural arachnoid cyst presenting with squatting-induced lower extremity symptoms: A case report.}},
author = {Sho Sato and Toshiyuki Takahashi and Ryo Kanematsu and Norihiko Saito},
journal = {Surgical neurology international},
year = {2026},
month = oct,
doi = {10.25259/sni_1132_2026},
url = {https://europepmc.org/article/MED/42974259},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Spinal extradural arachnoid cyst presenting with squatting-induced lower extremity symptoms: A case report.
AU - Sho Sato
AU - Toshiyuki Takahashi
AU - Ryo Kanematsu
AU - Norihiko Saito
PY - 2026
DA - 2026/10/16
JO - Surgical neurology international
DO - 10.25259/sni_1132_2026
UR - https://europepmc.org/article/MED/42974259
AB - Background Spinal extradural arachnoid cysts (SEACs) may cause progressive myelopathic or cauda equina symptoms but are often asymptomatic and incidentally detected. Determining symptom causality is challenging when radiological compression is mild.Case description A 73-year-old female presented with bilateral lower-extremity weakness induced by squatting. The neurological examination was unremarkable except for decreased lower-extremity reflexes. The magnetic resonance imaging revealed a SEAC at the T11-L1 level causing minimal neural compression. Myelography and cystography failed to identify a dural defect. Following direct cyst puncture, her squatting-induced symptoms resolved. She was, therefore, diagnosed with a symptomatic SEAC and successfully underwent cyst excision with dural repair. Postoperatively, her symptoms completely resolved within 1 week, and she was discharged after an uneventful postoperative course. At the 3-month follow-up, she remained symptom-free.Conclusion In certain cases, symptom resolution after direct spinal cyst puncture may help determine the clinical significance of SEACs. Posture-induced symptoms, such as those triggered by squatting, may provide important diagnostic clues as to how to treat symptomatic SEACs.
SN - 2229-5097
SN - 2152-7806
ER -