The authors report an unusual case of a child who presented with progressive paraparesis that lasted 15 days, revealing an intramedullary cystic lesion extending from T3 to T4 as detected with spine magnetic resonance imaging. A laminotomy from T3 to T4 was performed and the lesion removed. Histopathological findings confirmed the diagnosis of arachnoid cyst. After surgery, the patient’s neurological status improved. At the 4-month follow-up examination, the results of his neurological examinations remained normal. Arachnoid cyst is an entity that should be included in the differential diagnosis of intramedullary cystic lesions.

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