en Basic Neurosurgery Case report <div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:200%"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">Background and Importance:</span></span></span></b><i> </i><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">Neurenteric cysts (NCs) account for 0.7 to 1.3% of all spinal tumors</span></span></span> and are most <span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">commonly present during the first three decades of life. Only </span></span></span>two<span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times=""> cases </span></span></span>have been <span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">reported in individuals in their 7th and 8th decades of life. This study described a rare case of an NC in a septuagenarian<span style="background:white"> (70 &ndash; 79 years of age) who presented with atypical features of the disease. </span><i></i></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:200%"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">Case Presentation:</span></span></span></b><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times=""> A <span style="background:white">77-year-old female patient presented with acute onset paraparesis. Magnetic resonance imaging </span>revealed <span style="background:white">a 13.6 &times; 14.1 &times; 15.4 mm intradural extramedullary cystic lesion, which was anteriorly </span>located <span style="background:white">at the C7-D1 level. It was T1 hypointense, T2 hyperintense, and showed faint contrast enhancement </span>at the junction between the cyst and the spinal cord<span style="background:white">. At surgery, a cyst with a greyish-white thin wall was noted in the spinal canal, </span>displacing the spinal cord posteriorly<span style="background:white">. </span>The <span style="background:white">cyst wall was partially excised, and a small </span>portion <span style="background:white">adhering to the spinal cord was left behind. </span>The <span style="background:white">histopathology report was consistent with an NC. </span>At the 2-week follow-up<span style="background:white">, </span>the <span style="background:white">patient&rsquo;s lower limb </span>strength had <span style="background:white">improved.</span><i></i></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:200%"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">Conclusion</span></span></span></b><i><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">: </span></span></span></i><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">Although rare, NCs can present in the seventh decade of life<span style="background:white">. </span>Magnetic resonance imaging may reveal unusual findings, like T1 hypointensity and faint contrast enhancement of the cyst wall. In elderly patients, a portion of the cyst wall may be left behind if it adheres to the spinal cord to avoid the risk of neurological deterioration. </span></span></span></span></span></span><br> &nbsp;</div> Intradural-extramedullary, Magnetic resonance imaging, Neurenteric cyst, Spinal cord 134 139 http://irjns.org/browse.php?a_code=A-10-536-4&slc_lang=en&sid=1 Binoy Damodar Thavara drbinoytd@gmail.com 100319475328460011944 100319475328460011944 Yes Department of Neurosurgery, Government Medical College, Kozhikode, India. Rajeev Mandaka Parambil drrajeevmp@gmail.com 100319475328460011945 100319475328460011945 No Department of Neurosurgery, Government Medical College, Kozhikode, India. Byjo Valiyaveetil Jose byjovj@yahoo.co.in 100319475328460011946 100319475328460011946 No Department of Neurosurgery, Government Medical College, Kozhikode, India. Umasankar Parol umasankarantirur@gmail.com 100319475328460011947 100319475328460011947 No Department of Pathology, Government Medical College, Kozhikode, India. Prem kumar Sasi drpremks@gmail.com 100319475328460011948 100319475328460011948 No Department of Neurosurgery, Government Medical College, Kozhikode, India. Gorijavolu Sai Sree Krishna saisree.gorijavolu@gmail.com 100319475328460011949 0009-0006-6885-8689 No Department of Neurosurgery, Government Medical College, Kozhikode, India.