Intraspinal Intradural Arachnoid Web at the Thoracic Level: A Case Report

TL;DR

A 68-year-old woman with neurological symptoms had a rare spinal condition called an arachnoid web successfully surgically removed.

Contribution

This case report adds to the limited literature on intraspinal intradural arachnoid webs and their surgical management.

Findings

Surgical removal of the arachnoid web led to reduced leg pain and improved mobility.

MRI confirmed the presence of an intraspinal intradural mass at T4 with early myelopathy.

Pathological analysis showed connective tissue fragments consistent with an arachnoid cyst.

Abstract

Arachnoid web is a rare condition, which can cause significant neurological symptoms due to spinal cord compression. This case highlights the clinical presentation, surgical management, and pathology of an arachnoid web, contributing to the understanding of this rare condition. A 68-year-old female presented with diffuse pain syndrome, gait disturbance, and left leg pain. Clinical-neurological examination indicated myelopathy, confirmed by magnetic resonance imaging (MRI) revealing an intraspinal intradural mass at T4 with early signs of myelopathy. Surgical removal of the mass was performed via right-sided hemilaminectomy and microsurgical excision. Intraoperative findings included a cerebrospinal fluid (CSF)-filled pouch beneath an abnormal arachnoid membrane. Pathological analysis identified connective tissue fragments consistent with an arachnoid cyst, without atypia or inflammation. Postoperative recovery showed reduced leg pain and improved mobility.

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