Spontaneous hemorrhage into spinal neurenteric cyst.

CASE REPORT: A case of spontaneous hemorrhage into an intradural extramedullary neurenteric cyst at the C4-C6 level in a 6-year-old boy is reported. The child presented with sudden neck pain, torticollis, and myelopathy. The cyst was of high signal intensity on both T1- and T2-weighted magnetic resonance images, suggesting hemorrhage into the cyst. The combination of CT and MR provided useful preoperative information regarding the nature and the location of the cyst. A posterior approach via osteoplastic laminotomy was used for this anteriorly localized cyst. The use of intraoperative ultrasound was helpful in identifying and puncturing the cyst to minimize the spinal cord manipulation during the excision of the cyst wall. DISCUSSION: We report the first documented case of hemorrhage into a spinal neurenteric cyst that has been confirmed surgically and histopathologically.