{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T10:25:38Z","timestamp":1784715938517,"version":"3.55.0"},"reference-count":46,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"18","license":[{"start":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T00:00:00Z","timestamp":1698624000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,30]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Synovial cysts are a common finding in degenerative spine disease, most frequently involving the facet joints of the lumbar spine. Synovial cysts are less common in the cervical spine and rarely involve the atlantoaxial junction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>In this case report, the authors detail a unique presentation of a left atlantoaxial synovial cyst with large intracranial extension into the cerebellopontine angle causing progressive cranial nerve palsies resulting in tinnitus, vertigo, diminished hearing, gait imbalance, left trigeminal hypesthesia, left facial weakness, and dysarthria. The patient underwent a retromastoid craniectomy for resection of the synovial cyst, resulting in improvement and resolution of symptoms. Follow-up occurred at 6 weeks, 3 months, and 5 months postoperatively without recurrence on imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>The authors describe acute and long-term management of a unique presentation of an atlantoaxial synovial cyst including retromastoid craniectomy, intervals for follow-up for recurrence, and possible treatment options in cases of recurrence. A systematic literature review was also performed to explore all reported cases of craniocervical junction synovial cysts and subsequent surgical management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23373","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T20:31:38Z","timestamp":1698697898000},"source":"Crossref","is-referenced-by-count":1,"title":["Management of rare atlantoaxial synovial cyst case with extension to the cerebellopontine angle: illustrative case"],"prefix":"10.3171","volume":"6","author":[{"given":"Shawn","family":"D\u2019Souza","sequence":"first","affiliation":[{"name":"Virginia Commonwealth University: School of Medicine, Richmond, Virginia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikram","family":"Seshadri","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University: School of Medicine, Richmond, Virginia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harsh P","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Virginia Commonwealth University: Health, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan T","family":"Hachmann","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Virginia Commonwealth University: Health, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Scott","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Virginia Commonwealth University: Health, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Neurosurgery","first-page":"415","article-title":"Preoperative diagnosis of an extradural cyst arising from a spinal facet joint: case report","volume":"30","author":"Heary RF","year":"1992","unstructured":"Heary RF, Stellar S, Fobben ES. Preoperative diagnosis of an extradural cyst arising from a spinal facet joint: case report. Neurosurgery. 1992;30(3):415\u2013418."},{"issue":"4","key":"b2","series-title":"Neurosurgery","first-page":"642","article-title":"Synovial cysts of the spine","volume":"22","author":"Onofrio BM","year":"1988","unstructured":"Onofrio BM, Mih AD. Synovial cysts of the spine. Neurosurgery. 1988;22(4):642\u2013647."},{"issue":"3","key":"b3","series-title":"Surg Neurol","first-page":"239","article-title":"Synovial cyst at the craniovertebral junction","volume":"31","author":"Miller JD","year":"1989","unstructured":"Miller JD, al-Mefty O, Middleton TH 3rd. Synovial cyst at the craniovertebral junction. Surg Neurol. 1989;31(3):239\u2013242."},{"issue":"6","key":"b4","series-title":"J Neurosurg","first-page":"1027","article-title":"Synovial cyst and degeneration of the transverse ligament: an unusual cause of high cervical myelopathy. Case report","volume":"86","author":"Fransen P","year":"1997","unstructured":"Fransen P, Pizzolato GP, Otten P, Reverdin A, Lagier R, de Tribolet N. Synovial cyst and degeneration of the transverse ligament: an unusual cause of high cervical myelopathy. Case report. J Neurosurg. 1997;86(6):1027\u20131030."},{"issue":"2","key":"b5","series-title":"Zentralbl Neurochir","first-page":"86","article-title":"Intraspinal synovial cyst at the craniocervical junction","volume":"64","author":"Eustacchio S","year":"2003","unstructured":"Eustacchio S, Trummer M, Unger F, Flaschka G. Intraspinal synovial cyst at the craniocervical junction. Zentralbl Neurochir. 2003;64(2):86\u201389."},{"issue":"4","key":"b6","series-title":"J Clin Neurosci","first-page":"492","article-title":"Isolated unilateral hypoglossal nerve paralysis caused by an atlanto-occipital joint synovial cyst","volume":"10","author":"Mujic A","year":"2003","unstructured":"Mujic A, Hunn A, Liddell J, Taylor B, Havlat M, Beasley T. Isolated unilateral hypoglossal nerve paralysis caused by an atlanto-occipital joint synovial cyst. J Clin Neurosci. 2003;10(4):492\u2013495."},{"issue":"5","key":"b7","series-title":"J Neurosurg","first-page":"920","article-title":"Endoscope-assisted microsurgical resection of an intraneural ganglion cyst of the hypoglossal nerve","volume":"103","author":"Baldauf J","year":"2005","unstructured":"Baldauf J, Junghans D, Schroeder HWS. Endoscope-assisted microsurgical resection of an intraneural ganglion cyst of the hypoglossal nerve. J Neurosurg. 2005;103(5):920\u2013922."},{"issue":"3","key":"b8","series-title":"J Neurosurg Spine","first-page":"234","article-title":"Isolated unilateral hypoglossal nerve palsy secondary to an atlantooccipital joint juxtafacet synovial cyst","volume":"10","author":"Elhammady MS","year":"2009","unstructured":"Elhammady MS, Farhat H, Aziz-Sultan MA, Morcos JJ. Isolated unilateral hypoglossal nerve palsy secondary to an atlantooccipital joint juxtafacet synovial cyst. 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Br J Radiol. 2010;83(986):e35\u2013e38."},{"issue":"8","key":"b11","series-title":"Acta Neurochir (Wien)","first-page":"1583","article-title":"Intradural synovial cyst of the atlantoaxial joint: a case report","volume":"158","author":"Hartmann S","year":"2016","unstructured":"Hartmann S, Tschugg A, Kavakebi P, Thom\u00e9 C. Intradural synovial cyst of the atlantoaxial joint: a case report. Acta Neurochir (Wien). 2016;158(8):1583\u20131586."},{"key":"b12","series-title":"Interdiscip Neurosurg","first-page":"28","article-title":"Far-lateral trans-atlas extradural resection of retro-odontoid synovial cyst: surgical technique and review of literature","volume":"17","author":"Adada B","year":"2019","unstructured":"Adada B, Vera Silva MA, Darwish H, Dakwar E. Far-lateral trans-atlas extradural resection of retro-odontoid synovial cyst: surgical technique and review of literature. 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J Neurosurg. 2003;99(1)(suppl):14\u201319."},{"issue":"5","key":"b20","series-title":"Clin Spine Surg","first-page":"E296","article-title":"The prevalence of incidental and symptomatic lumbar synovial facet cysts","volume":"31","author":"Janssen SJ","year":"2018","unstructured":"Janssen SJ, Ogink PT, Schwab JH. The prevalence of incidental and symptomatic lumbar synovial facet cysts. Clin Spine Surg. 2018;31(5):E296\u2013E301."},{"key":"b21","series-title":"Int J Surg Case Rep","first-page":"90","article-title":"A rare cause of root-compression: Subaxial cervical synovial cyst in association with congenital fusion","volume":"16","author":"Breckwoldt T","year":"2015","unstructured":"Breckwoldt T, Oktenoglu T, Sasani M, Suzer T, Ozer AF. A rare cause of root-compression: Subaxial cervical synovial cyst in association with congenital fusion. Int J Surg Case Rep. 2015;16:90\u201392."},{"issue":"7","key":"b22","series-title":"Neurol Med Chir (Tokyo)","first-page":"539","article-title":"Craniocervical junction synovial cyst associated with atlanto-axial dislocation\u2014case report","volume":"39","author":"Akiyama H","year":"1999","unstructured":"Akiyama H, Tamaki N, Kondoh T, Nagashima T. Craniocervical junction synovial cyst associated with atlanto-axial dislocation\u2014case report. Neurol Med Chir (Tokyo). 1999;39(7):539\u2013543."},{"key":"b23","series-title":"J Med Assoc Thai","first-page":"S120","article-title":"Complete spontaneous regression of the intraspinal synovial cyst at the C1-C2 junction following with atlantoaxial fusion of non-union odontoid fracture: a case report","volume":"99","author":"Tangviriyapaiboon T","year":"2016","unstructured":"Tangviriyapaiboon T. Complete spontaneous regression of the intraspinal synovial cyst at the C1-C2 junction following with atlantoaxial fusion of non-union odontoid fracture: a case report. J Med Assoc Thai. 2016;99(suppl 3):S120\u2013S125."},{"issue":"3","key":"b1","series-title":"Neurosurgery","first-page":"415","article-title":"Preoperative diagnosis of an extradural cyst arising from a spinal facet joint: case report","volume":"30","author":"Heary RF","year":"1992","unstructured":"Heary RF, Stellar S, Fobben ES. Preoperative diagnosis of an extradural cyst arising from a spinal facet joint: case report. Neurosurgery. 1992;30(3):415\u2013418."},{"issue":"4","key":"b2","series-title":"Neurosurgery","first-page":"642","article-title":"Synovial cysts of the spine","volume":"22","author":"Onofrio BM","year":"1988","unstructured":"Onofrio BM, Mih AD. Synovial cysts of the spine. Neurosurgery. 1988;22(4):642\u2013647."},{"issue":"3","key":"b3","series-title":"Surg Neurol","first-page":"239","article-title":"Synovial cyst at the craniovertebral junction","volume":"31","author":"Miller JD","year":"1989","unstructured":"Miller JD, al-Mefty O, Middleton TH 3rd. Synovial cyst at the craniovertebral junction. Surg Neurol. 1989;31(3):239\u2013242."},{"issue":"6","key":"b4","series-title":"J Neurosurg","first-page":"1027","article-title":"Synovial cyst and degeneration of the transverse ligament: an unusual cause of high cervical myelopathy. Case report","volume":"86","author":"Fransen P","year":"1997","unstructured":"Fransen P, Pizzolato GP, Otten P, Reverdin A, Lagier R, de Tribolet N. Synovial cyst and degeneration of the transverse ligament: an unusual cause of high cervical myelopathy. Case report. 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J Clin Neurosci. 2003;10(4):492\u2013495."},{"issue":"5","key":"b7","series-title":"J Neurosurg","first-page":"920","article-title":"Endoscope-assisted microsurgical resection of an intraneural ganglion cyst of the hypoglossal nerve","volume":"103","author":"Baldauf J","year":"2005","unstructured":"Baldauf J, Junghans D, Schroeder HWS. Endoscope-assisted microsurgical resection of an intraneural ganglion cyst of the hypoglossal nerve. J Neurosurg. 2005;103(5):920\u2013922."},{"issue":"3","key":"b8","series-title":"J Neurosurg Spine","first-page":"234","article-title":"Isolated unilateral hypoglossal nerve palsy secondary to an atlantooccipital joint juxtafacet synovial cyst","volume":"10","author":"Elhammady MS","year":"2009","unstructured":"Elhammady MS, Farhat H, Aziz-Sultan MA, Morcos JJ. Isolated unilateral hypoglossal nerve palsy secondary to an atlantooccipital joint juxtafacet synovial cyst. J Neurosurg Spine. 2009;10(3):234\u2013239."},{"issue":"5","key":"b9","series-title":"Br J Neurosurg","first-page":"595","article-title":"Synovial cyst presenting as a C1\/2 tumour","volume":"24","author":"Harries A","year":"2010","unstructured":"Harries A, Wasserberg J. Synovial cyst presenting as a C1\/2 tumour. Br J Neurosurg. 2010;24(5):595\u2013596."},{"issue":"986","key":"b10","series-title":"Br J Radiol","first-page":"e35","article-title":"Case report. Atlantoaxial synovial cyst causing isolated unilateral hypoglossal nerve paralysis","volume":"83","author":"Mendes-Ara\u00fajo L","year":"2010","unstructured":"Mendes-Ara\u00fajo L, Rangel C, Domingues RC, Gasparetto EL. Case report. Atlantoaxial synovial cyst causing isolated unilateral hypoglossal nerve paralysis. Br J Radiol. 2010;83(986):e35\u2013e38."},{"issue":"8","key":"b11","series-title":"Acta Neurochir (Wien)","first-page":"1583","article-title":"Intradural synovial cyst of the atlantoaxial joint: a case report","volume":"158","author":"Hartmann S","year":"2016","unstructured":"Hartmann S, Tschugg A, Kavakebi P, Thom\u00e9 C. Intradural synovial cyst of the atlantoaxial joint: a case report. Acta Neurochir (Wien). 2016;158(8):1583\u20131586."},{"key":"b12","series-title":"Interdiscip Neurosurg","first-page":"28","article-title":"Far-lateral trans-atlas extradural resection of retro-odontoid synovial cyst: surgical technique and review of literature","volume":"17","author":"Adada B","year":"2019","unstructured":"Adada B, Vera Silva MA, Darwish H, Dakwar E. Far-lateral trans-atlas extradural resection of retro-odontoid synovial cyst: surgical technique and review of literature. Interdiscip Neurosurg. 2019;17:28\u201335."},{"key":"b13","series-title":"World Neurosurg","first-page":"148","article-title":"Retro-odontoid pseudotumor: two cases of intradural ganglion cysts arising from the odontoid process with syringobulbia","volume":"144","author":"Miyazawa R","year":"2020","unstructured":"Miyazawa R, Miyawaki S, Yamada K,  Retro-odontoid pseudotumor: two cases of intradural ganglion cysts arising from the odontoid process with syringobulbia. World Neurosurg. 2020;144:148\u2013153."},{"issue":"1","key":"b14","series-title":"Cureus","first-page":"e21715","article-title":"Retro-odontoid intradural synovial cyst decompression via endoscopic-assisted far-lateral approach C1-C2 hemilaminectomy without fusion: the use of intracranial denticulate ligament as intraoperative landmark","volume":"14","author":"Fana M","year":"2022","unstructured":"Fana M, Deamont C, Medani K,  Retro-odontoid intradural synovial cyst decompression via endoscopic-assisted far-lateral approach C1-C2 hemilaminectomy without fusion: the use of intracranial denticulate ligament as intraoperative landmark. Cureus. 2022;14(1):e21715."},{"issue":"1","key":"b15","series-title":"Rev Pain","first-page":"8","article-title":"Lumbar zygapophyseal (facet) joint pain","volume":"2","author":"Saravanakumar K","year":"2008","unstructured":"Saravanakumar K, Harvey A. Lumbar zygapophyseal (facet) joint pain. Rev Pain. 2008;2(1):8\u201313."},{"issue":"8","key":"b16","series-title":"Spine (Phila Pa 1976)","first-page":"969","article-title":"Patient outcome after resection of lumbar juxtafacet cysts","volume":"26","author":"Banning CS","year":"2001","unstructured":"Banning CS, Thorell WE, Leibrock LG. Patient outcome after resection of lumbar juxtafacet cysts. Spine (Phila Pa 1976). 2001;26(8):969\u2013972."},{"issue":"1","key":"b17","series-title":"Spine (Phila Pa 1976)","first-page":"80","article-title":"Lumbar intraspinal synovial and ganglion cysts (facet cysts). Ten-year experience in evaluation and treatment","volume":"20","author":"Hsu KY","year":"1995","unstructured":"Hsu KY, Zucherman JF, Shea WJ, Jeffrey RA. Lumbar intraspinal synovial and ganglion cysts (facet cysts). Ten-year experience in evaluation and treatment. Spine (Phila Pa 1976). 1995;20(1):80\u201389."},{"issue":"8","key":"b18","series-title":"Eur Spine J","first-page":"1176","article-title":"Spinal lumbar synovial cysts. Diagnosis and management challenge","volume":"15","author":"Khan AM","year":"2006","unstructured":"Khan AM, Girardi F. Spinal lumbar synovial cysts. Diagnosis and management challenge. Eur Spine J. 2006;15(8):1176\u20131182."},{"issue":"1","key":"b19","series-title":"J Neurosurg","first-page":"14","article-title":"Synovial cysts of the lumbar spine: surgery-related results and outcome","volume":"99","author":"Pirotte B","year":"2003","unstructured":"Pirotte B, Gabrovsky N, Massager N, Levivier M, David P, Brotchi J. Synovial cysts of the lumbar spine: surgery-related results and outcome. J Neurosurg. 2003;99(1)(suppl):14\u201319."},{"issue":"5","key":"b20","series-title":"Clin Spine Surg","first-page":"E296","article-title":"The prevalence of incidental and symptomatic lumbar synovial facet cysts","volume":"31","author":"Janssen SJ","year":"2018","unstructured":"Janssen SJ, Ogink PT, Schwab JH. The prevalence of incidental and symptomatic lumbar synovial facet cysts. Clin Spine Surg. 2018;31(5):E296\u2013E301."},{"key":"b21","series-title":"Int J Surg Case Rep","first-page":"90","article-title":"A rare cause of root-compression: Subaxial cervical synovial cyst in association with congenital fusion","volume":"16","author":"Breckwoldt T","year":"2015","unstructured":"Breckwoldt T, Oktenoglu T, Sasani M, Suzer T, Ozer AF. A rare cause of root-compression: Subaxial cervical synovial cyst in association with congenital fusion. 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Complete spontaneous regression of the intraspinal synovial cyst at the C1-C2 junction following with atlantoaxial fusion of non-union odontoid fracture: a case report. 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