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Cervicothoracic Extradural Arachnoid Cyst: Possible Association With Obstetric Brachial Plexus Palsy

Department of Pediatrics Hospital Clinico San Carlos Universidad Complutense Madrid, Spain

Scarlett Sinisterra, MD

Department of Pediatrics Miami Children's Hospital Miami, Florida

Sherri Birchansky, MD

Department of Radiology Miami Children's Hospital Miami, Florida

Oscar Papazian, MD

Brachial Plexus Program Department of Neurology Miami Children's Hospital and University of Miami Miami, Florida

Gerry Tuite, MD

Department of Neurosurgery South Florida University St. Petersburg, Florida

John A.I. Grossman, MD

Brachial Plexus Program Miami Children's Hospital Miami, Florida

Israel Alfonso, MD

Brachial Plexus Program Department of Neurology Miami Children's Hospital and University of Miami Miami, Florida, ialfonzo{at}mail.pediatricneuro.com

The association of cervicothoracic extradural arachnoid cysts and obstetric brachial plexus palsy has not previously been reported. We report two patients with this association. The first patient is a 9-month-old boy with left obstetric brachial plexus palsy that developed bilateral leg weakness at 6 months of age owing to compression of the spinal cord by a C6 to T8 left cervicothoracic extradural arachnoid cyst. The second patient is a 3-year-old girl with bilateral brachial plexus palsy and spastic paraparesis who had magnetic resonance imaging at 3 days of age that showed intraspinal cord injury and a cervicothoracic extradural arachnoid cyst compressing the spinal cord. We believe that the association of cervicothoracic epidural arachnoid cysts and obstetric brachial plexus palsy in these patients was causal and recommend that the possibility of a cervicothoracic epidural arachnoid cyst be considered in patients with brachial plexus palsy and evidence of spinal cord injury. (J Child Neurol 2002;17:770—772).

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