title: [Clinical presentation of a dorsal epidural arachnoid cyst after an epidural anesthesia].
abstract: BACKGROUND
  Arachnoid cysts are dural diverticula with liquid content similar to cerebrospinal fluid, with 1% occurring in the spinal cord. They locate mainly in the dorsal region of the thoracic spine, and are unusual causes of spinal cord compression.
  
  
  METHODS
  The case is presented of a previously healthy 15-year-old boy, with a 20-month history of spastic paraparesis that started apparently after epidural block for ankle osteosynthesis. There was decreased sensitivity and strength of the pelvic limbs and gradually presented with anaesthesia from T12 to L4 dermatomes, L5 and S1 bilateral hypoaesthesia and 4+/5 bilateral strength, in the L2 root and 2+/5 in L3, L4, L5, S1, hyperreflexia, Babinski and clonus, but with no alteration in the sacral reflexes. In the magnetic resonance it was diagnosed as an extradural arachnoid cyst from T6 to T9. The patient underwent a T6 to T10 laminotomy, cyst resection, dural defect suture, and laminoplasty. One year after surgery, the patient had recovered sensitivity, improvement of muscle strength up to 4+/5 in L2 to S1, and normal reflexes.
  
  
  CONCLUSIONS
  After the anaesthetic procedure, increased pressure and volume changes within the cyst could cause compression of the spinal cord, leading to symptoms. Despite being a long-term compression, the patient showed noticeable improvement.
authors.affiliation: División de Cirugía de Columna Vertebral, Instituto Nacional de Rehabilitación, Ciudad de México, México.
authors.forename: Claudia Alejandra
authors.initials: CA
authors.lastname: Obil-Chavarría
authors.affiliation: División de Cirugía de Columna Vertebral, Instituto Nacional de Rehabilitación, Ciudad de México, México.
authors.forename: Carla Lisette
authors.initials: CL
authors.lastname: García-Ramos
authors.affiliation: División de Cirugía de Columna Vertebral, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México.
authors.forename: Sergio Alberto
authors.initials: SA
authors.lastname: Castro-Quiñonez
authors.affiliation: Servicio de Neurocirugía, Centro Médico Adolfo López Mateos, Instituto de Salud del Estado de México y Municipios, Toluca de Lerdo, México.
authors.forename: Raúl
authors.initials: R
authors.lastname: Huato-Reyes
authors.affiliation: Servicio de Rehabilitación Pediátrica, Instituto Nacional de Rehabilitación, Ciudad de México, México.
authors.forename: Concepción Guadalupe
authors.initials: CG
authors.lastname: Santillán-Chapa
authors.affiliation: División de Cirugía de Columna Vertebral, Instituto Nacional de Rehabilitación, Ciudad de México, México. Electronic address: alereyes@inr.gob.mx.
authors.forename: Alejandro Antonio
authors.initials: AA
authors.lastname: Reyes-Sánchez
mesh_terms: D000293:Adolescent; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D064386:Ankle Fractures / Q000601:surgery; D016080:Arachnoid Cysts / Q000145:classification / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D015170:Cerebrospinal Fluid Pressure; D004824:Epidural Space; D005593:Fracture Fixation, Internal; D006801:Humans; D007796:Laminectomy; D065406:Laminoplasty; D008297:Male; D020336:Paraparesis, Spastic / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D020127:Recovery of Function; D012678:Sensation Disorders / Q000209:etiology; D013117:Spinal Cord Compression / Q000209:etiology; D013904:Thoracic Vertebrae
keywords: Clinical outcome; Compresión medular; Evolución clínica; Quistes aracnoideos espinales; Spinal arachnoid cysts; Spinal cord compression; Surgical treatment; Tratamiento quirúrgico