The patient came to the clinic 20-May-2002 with parents telling that he was born full term and got left brachial plexus traction injury with fracture right femur and right clavicle. H/C was 37 cm  and total paralysis of the all trunks of left brachial plexus were noted. The patient then came 09-September-2002 with signs of improvement of the upper part of the brachial plexus.

On examination: the patient with soft lax abdomen and normal peristaltic sounds. The fontanel is normal. H/C 44 cm. The lower part of the brachial plexus still the same.

The patient sent for investigations for MRI cervical spine with MR Myelography and ECS, which were done and showing a huge extradural cyst extending from left C6 down to D5 with origin from left Th1, compressing the spinal cord.

Left hemilaminectomy of D1-2 with plication of the cyst with gradual pulling the extent of the cyst from above and below. This was done until the left Th1 root was identified and preserved. Complete resection of the sac was achieved. The harvested bone from the hemilaminectomy was returned in place after applying a piece of long muscle over the dura. Routine closure of the wound.

The patient came to the clinic 05-November-2003 with clean wound and the parents were advised to perform MRI and EMG after 45 days with physiotherapy.

The patient then came 18-February-2004 with MRI done 14-February-2004 with complete resection of the sac and EMG showed some improvement of C5-Th1 innervation.

The huge extradural cyst is mostly is part of his primary insult, but gradually progressed. Surgical removal was needed to avoid further damage to the spinal cord. This case is a rarity and in the literature it has no similar report.