Intraspinal cysts in children clinical and neuroradiological features in two cases

Spinal malformation or compressive lesions in infancy may present with insidious, sometimes atypical symptoms which hinder accurate diagnosis. We describe two children with intraspinal cysts unaccompanied by spinovertebral deformity which were difficult to diagnose clinically and neuroradiologically. Two 19-month-old infants were referred to us. One had worsening pain in the head and neck and was forced to lie on his side; the other infant had non-epileptic atonic seizures in his legs, flexion contractions in the head and arms and subsequent spastic paraparesis in the course of meningococcal sepsis without meningitis. The first infant had a cervical extramedullary intradural neuroenteric cyst; the second had an isolated extramedullary intradural subarachnoid cyst in the thoracic region. In both cases diagnosis was established by combined MR and myelo-CT investigation. Surgical removal resolved symptoms in both children. Though rare, spinal cysts should be suspected when infants present with spinal pain and/or impairment of uncertain origin. MR with or without myelo-CT is useful in identifying these lesions.