Two pediatric patients (4 and 5 years of age) with spinal intramedullary ependymal cysts located at the cervical and dorsal cord are reported here. One patient was admitted with subtle signs, while the other had disabling spastic quadriparesis. In both patients, MRI depicted a well-demarcated, localized, nonenhancing intramedullary lesion isointense with CSF on T1- and T2-weighted images. Total excision of the covering membrane of the cyst was not possible in either case. The child with spastic quadriparesis had a remarkable recovery, while the subtle signs of the other patient regained normalcy at the follow-up of 4 and 5 months, respectively.

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