Teaching NeuroImages: Intraspinal synovial cyst causing Brown-Sequard syndrome: Uncommon cause of a classic syndrome

A 65-year-old woman with osteoarthritis presented with 6 weeks of insidiously worsening numbness in the left hemibody and weakness in the right arm and leg. Examination revealed pyramidal weakness in the right arm and leg with hyperreflexia, right Babinski sign, left-sided C4 sensory level to pinprick and temperature, and reduced proprioception in the right extremities. Cervical spine MRI revealed a facet joint synovial cyst at C2-C3 compressing the right hemicord (figure). This was excised, with only mild numbness at 6 months postoperatively. Symptomatic intraspinal cervical synovial cysts are rare and an uncommon cause of myelopathy, typically occurring at C7-T1.1,2
Source: Neurology - Category: Neurology Authors: Tags: MRI, Clinical neurology history, Clinical neurology examination, All Spinal Cord RESIDENT AND FELLOW SECTION Source Type: research