Arachnoid Cyst

Pediatric spinal arachnoid cysts are rare, fluid-filled sacs that develop within or adjacent to the arachnoid membrane surrounding the spinal cord. Although often benign, these cysts can cause significant spinal cord compression, leading to progressive neurological symptoms, including pain, weakness, and bladder or bowel dysfunction. Early detection and timely neurosurgical intervention are crucial to prevent permanent deficits in affected children. In Bangladesh, due to limited awareness and lack of specialized imaging, many cases go undiagnosed or are misinterpreted as general back problems. Dr. Md. Nafaur Rahman, a leading pediatric neurosurgeon in the country, offers specialized expertise in diagnosing and surgically managing spinal arachnoid cysts using state-of-the-art neurosurgical techniques. What is a Spinal Arachnoid Cyst? A spinal arachnoid cyst is a cerebrospinal fluid (CSF)-filled sac located within the layers of the arachnoid membrane of the spinal cord. These cysts can be: Intradural (inside the dura mater but outside the spinal cord) Extradural (outside the dura but within the spinal canal) Congenital or acquired, but in children, they are usually congenital Causes and Types Congenital Arachnoid Cyst Result from developmental abnormalities during fetal life Present at birth but may remain asymptomatic until later Acquired Arachnoid Cyst Rare in children Can occur due to trauma, surgery, meningitis, or hemorrhage Common Locations in Pediatric Patients Thoracic spine – most frequent site Cervical or lumbar regions – less common Can occur at any level and may extend over multiple vertebrae Clinical Symptoms Spinal arachnoid cysts grow slowly and symptoms may be subtle or mistaken for orthopedic or developmental issues: Progressive back pain or discomfort Lower limb weakness or spasticity Gait disturbances or frequent falls Numbness, tingling, or sensory changes Loss of bladder or bowel control in advanced cases Scoliosis or spinal deformity if the cyst is large In Bangladesh, children are often brought in after symptoms have worsened, due to limited awareness in rural and semi-urban areas. Diagnosis in Bangladesh Dr. Md. Nafaur Rahman utilizes a structured diagnostic process to ensure accurate and timely diagnosis. 1. Clinical Evaluation Neurological exam to assess motor, sensory, and reflex changes Bladder and bowel assessment Family and developmental history review 2. Imaging Studies MRI of the spine with contrast – gold standard to visualize cyst size, location, and spinal cord compression CT scan – useful for assessing associated bony deformities Spinal ultrasound – in neonates or infants with suspected spinal anomalies Surgical Treatment Symptomatic arachnoid cysts require surgical intervention to decompress the spinal cord and relieve neurological pressure. Goals of Surgery Drainage or removal of the cyst Relief of spinal cord or nerve root compression Preservation of neurological function Prevention of cyst recurrence Dr. Nafaur Rahman’s Surgical Techniques Microsurgical cyst fenestration or excision Laminectomy or laminoplasty to access the cyst Use of intraoperative microscopy and neuro-monitoring Minimally invasive approaches when applicable Postoperative neuro-rehabilitation support Prognosis Most children experience significant improvement following surgery Prognosis is better when the cyst is treated before irreversible nerve damage Lifelong follow-up may be needed to monitor for recurrence or spinal alignment Challenges in the Bangladeshi Context Delayed diagnosis due to lack of pediatric spinal MRI facilities Low awareness among general practitioners and pediatricians Misdiagnosis as orthopedic issues, especially in rural areas Limited access to pediatric neurosurgeons outside Dhaka Financial constraints impacting timely surgical treatment Why Choose Dr. Md. Nafaur Rahman? Specialized in complex spinal surgeries in children Offers care at both NINS (government institute) and Bangladesh Paediatric Neurocare Centre (private center) Experienced in microsurgical and minimally invasive techniques Provides multidisciplinary care, including neurology, urology, and rehabilitation Committed to affordable and compassionate care tailored to each child’s needs Contact for Appointment Dr. Md. Nafaur Rahman Assistant Professor, Pediatric Neurosurgery National Institute of Neurosciences & Hospital (NINS) Chief Consultant, Bangladesh Paediatric Neurocare Centre 📞 For Appointment/Serial: 01912988182 | 01607033535 🌐 Website: www.neurosurgeonnafaur.com