{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:38:35Z","timestamp":1792543115739,"version":"4.5.0"},"reference-count":15,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"16","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,10,19]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Spinal intradural arachnoid cysts (SIACs) are relatively rare, but they can cause neurological symptoms. The authors report a case of an infant with an SIAC presenting with motor developmental delay, highlighting the intraoperative improvement of motor evoked potentials (MEPs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 14-month-old girl presented with a lower limb motor developmental delay. Spinal MRI revealed an SIAC at the C7\u2013T4 level, compressing the spinal cord from the dorsal side. She underwent surgical fenestration of the cyst. Intraoperatively, transcranial MEP amplitudes in the lower extremities were initially lower than those in the upper extremities. Following cyst fenestration and decompression, the MEP amplitudes increased more than 10-fold compared to the baseline and were maintained. Postoperatively, her motor functions gradually improved. By 5 months after surgery, her developmental delay had resolved, and she achieved age-appropriate motor milestones.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>In this pediatric case of an SIAC, surgical decompression led to a significant and immediate increase in MEP amplitudes. This physiological change was followed by an improvement in the patient\u2019s motor development, suggesting that intraoperative MEP monitoring can be a useful tool for evaluating the immediate effect of decompression in infants with an SIAC.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26285\">https:\/\/thejns.org\/doi\/10.3171\/CASE26285<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26285","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:01:05Z","timestamp":1791936065000},"source":"Crossref","is-referenced-by-count":0,"title":["Spinal intradural arachnoid cyst in an infant with motor developmental delay showing intraoperative MEP improvement: illustrative case"],"prefix":"10.3171","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8586-0859","authenticated-orcid":true,"given":"Ayako","family":"Toda","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Miyagi Children\u2019s Hospital, Sendai, Miyagi;"},{"name":"Department of Neurosurgery, Fukushima Medical University, Fukushima, Fukushima"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichiro","family":"Nagai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fukushima Medical University, Fukushima, Fukushima"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitomo","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fukushima Medical University, Fukushima, Fukushima"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuka","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ohta Nishinouchi Hospital Koriyama, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroto","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fukushima Medical University, Fukushima, Fukushima"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9606-2542","authenticated-orcid":true,"given":"Toshiaki","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Miyagi Children\u2019s Hospital, Sendai, Miyagi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masazumi","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fukushima Medical University, Fukushima, Fukushima"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"bib1","series-title":"Pediatr Neurosurg","first-page":"181","article-title":"Symptomatic spinal intradural arachnoid cysts in the pediatric age group: description of three new cases and review of the literature","volume":"35","author":"Lee","year":"2001","unstructured":"Lee HJCho DY.Symptomatic spinal intradural arachnoid cysts in the pediatric age group: description of three new cases and review of the literature. Pediatr Neurosurg. 2001;35(4):181-187. doi:10.1159\/000050419"},{"key":"bib2","series-title":"World Neurosurg","first-page":"e298","article-title":"Systematic review of surgical management of spinal intradural arachnoid cysts","volume":"158","author":"Baig Mirza","year":"2022","unstructured":"Baig Mirza ABartram JVastani ASystematic review of surgical management of spinal intradural arachnoid cysts. World Neurosurg. 2022;158:e298-e309. doi:10.1016\/j.wneu.2021.10.173"},{"issue":"4","key":"bib3","series-title":"J Neurosurg Pediatr","first-page":"432","article-title":"Spinal arachnoid cysts in the pediatric population: report of 31 cases and a review of the literature","volume":"9","author":"Bond","year":"2012","unstructured":"Bond AEZada GBowen IMcComb JGKrieger MD.Spinal arachnoid cysts in the pediatric population: report of 31 cases and a review of the literature. J Neurosurg Pediatr. 2012;9(4):432-441. doi:10.3171\/2012.1.PEDS11391"},{"key":"bib4","series-title":"World Neurosurg","first-page":"e637","article-title":"Intradural spinal arachnoid cysts in children: a collective experience of 2 centers","volume":"177","author":"Y\u0131lmaz","year":"2023","unstructured":"Y\u0131lmaz EGezer B\u015een HEIntradural spinal arachnoid cysts in children: a collective experience of 2 centers. World Neurosurg. 2023;177:e637-e643. doi:10.1016\/j.wneu.2023.06.115"},{"issue":"10","key":"bib5","series-title":"J Child Neurol","first-page":"1209","article-title":"Neurological examination of difficult and poorly cooperative children","volume":"22","author":"Jan","year":"2007","unstructured":"Jan MMS.Neurological examination of difficult and poorly cooperative children. J Child Neurol. 2007;22(10):1209-1213. doi:10.1177\/0883073807306262"},{"issue":"10","key":"bib6","series-title":"JAMA Netw Open","first-page":"e2539441","article-title":"Differentiating transient from persistent developmental delays in a nationwide infant cohort","volume":"8","author":"Bilu","year":"2025","unstructured":"Bilu YAmit GMayer Lapidot KDifferentiating transient from persistent developmental delays in a nationwide infant cohort. JAMA Netw Open. 2025;8(10):e2539441. doi:10.1001\/jamanetworkopen.2025.39441"},{"issue":"4","key":"bib7","series-title":"Auris Nasus Larynx","first-page":"498","article-title":"Developmental delays assessed using the Enjoji Scale in children with cochlear implants who have intellectual disability with or without autism spectrum disorder","volume":"46","author":"Motegi","year":"2019","unstructured":"Motegi MInagaki AMinakata TDevelopmental delays assessed using the Enjoji Scale in children with cochlear implants who have intellectual disability with or without autism spectrum disorder. Auris Nasus Larynx. 2019;46(4):498-506. doi:10.1016\/j.anl.2018.12.003"},{"issue":"22","key":"bib8","series-title":"Medicine (Baltimore)","first-page":"e25468","article-title":"Infant with right hemiplegia due to acute encephalopathy with biphasic seizures and late reduced diffusion (AESD): a case report","volume":"100","author":"Takahashi","year":"2021","unstructured":"Takahashi AKamei ESato YInfant with right hemiplegia due to acute encephalopathy with biphasic seizures and late reduced diffusion (AESD): a case report. Medicine (Baltimore). 2021;100(22):e25468. doi:10.1097\/MD.0000000000025468"},{"issue":"20","key":"bib9","series-title":"J Neurosurg Case Lessons","first-page":"CASE23478","article-title":"Symptomatic spinal arachnoid cyst with spastic diplegia secondary to cerebral palsy: illustrative case","volume":"6","author":"Guillotte","year":"2023","unstructured":"Guillotte AAlkiswani ARKeeler KAPartington MD.Symptomatic spinal arachnoid cyst with spastic diplegia secondary to cerebral palsy: illustrative case. J Neurosurg Case Lessons. 2023;6(20):CASE23478. doi:10.3171\/CASE23478"},{"issue":"6","key":"bib10","series-title":"J Neurosurg Case Lessons","first-page":"CASE23217","article-title":"Pediatric intraspinal arachnoid cyst: successful endoscopic fenestration. Illustrative case","volume":"6","author":"Horak","year":"2023","unstructured":"Horak VJJimenez MJDLoPresti MARaskin JS.Pediatric intraspinal arachnoid cyst: successful endoscopic fenestration. Illustrative case. J Neurosurg Case Lessons. 2023;6(6):CASE23217. doi:10.3171\/CASE23217"},{"issue":"6","key":"bib11","series-title":"Eur Spine J","first-page":"1875","article-title":"Prognostic value of intraoperative MEP signal improvement during surgical treatment of cervical compressive myelopathy","volume":"25","author":"Wang","year":"2016","unstructured":"Wang STian YWang CPrognostic value of intraoperative MEP signal improvement during surgical treatment of cervical compressive myelopathy. Eur Spine J. 2016;25(6):1875-1880. doi:10.1007\/s00586-016-4477-5"},{"issue":"1","key":"bib12","series-title":"Pediatrics","first-page":"13","article-title":"The significance of the Babinski sign in the newborn\u2014a reappraisal","volume":"57","author":"Ross","year":"1976","unstructured":"Ross EDVelez-Bprras JRosman NP.The significance of the Babinski sign in the newborn\u2014a reappraisal. Pediatrics. 1976;57(1):13-15. doi:10.1542\/peds.57.1.13"},{"issue":"4","key":"bib13","series-title":"J Pediatr","first-page":"568","article-title":"The rise and fall of the plantar response in infancy","volume":"133","author":"Gingold","year":"1998","unstructured":"Gingold MKJaynes MEBodensteiner JBRomano JTHammond MT.The rise and fall of the plantar response in infancy. J Pediatr. 1998;133(4):568-570. doi:10.1016\/S0022-3476(98)70071-X"},{"key":"bib14","series-title":"Biomed Res Int","article-title":"Pathophysiology of spasticity: implications for neurorehabilitation","volume":"2014","author":"Trompetto","year":"2014","unstructured":"Trompetto CMarinelli LMori LPathophysiology of spasticity: implications for neurorehabilitation. Biomed Res Int. 2014;2014:354906. doi:10.1155\/2014\/354906"},{"key":"bib15","series-title":"BioMedicine","article-title":"Effect of corticospinal and reticulospinal tract damage on spastic muscle tone and mobility: a retrospective observational MRI study","volume":"118","author":"Schading-Sassenhausen","year":"2025","unstructured":"Schading-Sassenhausen SDietz VFreund P.Effect of corticospinal and reticulospinal tract damage on spastic muscle tone and mobility: a retrospective observational MRI study. eBioMedicine. 2025;118:105824. doi:10.1016\/j.ebiom.2025.105824"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/16\/article-CASE26285.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/16\/article-CASE26285.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/16\/article-CASE26285.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:01:05Z","timestamp":1792540865000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/16\/article-CASE26285.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,19]]},"references-count":15,"journal-issue":{"issue":"16"},"URL":"https:\/\/doi.org\/10.3171\/case26285","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,19]]}}}