Spontaneous regression of a symptomatic atlanto-occipital joint cyst. Case report.

Synovial cysts (SCs) are well-recognized entities occurring at various spinal sites, although atlanto-occipital joint cyst is a rare occurrence. Similarly both hypoglossal nerve palsy (as an initial clinical onset) and spontaneous cervical cyst resolution are rare. In this report, the authors describe an atlanto-occipital SC revealed by hypoglossal nerve palsy in a 75-year-old woman. Due to the paucity of neurological signs and the patient's advanced age, she was managed conservatively; 8 months later the cyst resolved completely. We discuss the potential factors involved in the pathogenesis and the therapeutic options for this uncommon cervical entity. We advise conservative treatment as a first therapeutic option for SC without signs of spinal cord compression.