Ventrally placed craniovertebral junction arachnoid cysts in children: a report of 2 cases and literature review

BackgroundArachnoid cysts at the craniovertebral junction are uncommon, and all the reported cases had location posterior to the brain stem. We describe 2 cases of ventral arachnoid cysts among children.Case DescriptionTwo children, in their first decades of life, presented with spastic quadriparesis without complaints of raised intracranial pressure. Magnetic resonance imaging showed large, ventrally located cystic lesions compressing the brain stem and extending from posterior fossa to the lower level of C4 vertebra. Both patients underwent surgery via midline posterior fossa approach and fenestration of cysts along with partial excision. Both patients made complete recovery and are asymptomatic in the long-term outcome.ConclusionVentral arachnoid cysts at the craniovertebral junction present in the pediatric age group because of compression of corticospinal tracts. These patients have good long-term outcome after fenestration and partial cyst excision.