• Laurent Thines, Chadi Khalil, Anthony Fichten, and Jean-Paul Lejeune.
• Department of Neurosurgery, Centre Hospitalier Régional et Universitaire de Lille, Lille, France. Laurent.Thines@wanadoo.fr
• Neurosurgery. 2005 Oct 1; 57 (4): E817.

Objective And ImportanceWe report the first case of a delayed symptomatic spinal arachnoid cyst related to a nonaneurysmal perimesencephalic hemorrhage. We review the literature concerning posthemorrhagic spinal arachnoid cysts.Clinical PresentationA 64-year-old woman presented with progressive spinal cord compression symptoms 10 months after a nonaneurysmal perimesencephalic hemorrhage. Magnetic resonance imaging of the spine disclosed a dorsal and intradural cystic lesion producing posterior spinal cord compression.InterventionA thoracic laminectomy allowed complete resection of the cyst. Surgical and histological findings disclosed an intradural arachnoid cyst. On postoperative follow-up, spinal magnetic resonance imaging confirmed satisfactory decompression of the spinal cord. Because of extensive arachnoiditis, the patient experienced only partial recovery from neurological deficits.ConclusionThis extremely rare complication should be kept in mind when delayed lower-limb neurological deficits appear after subarachnoid hemorrhage, even in a perimesencephalic form.

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