Compressive myelopathy secondary to posthemorragic arachnoiditis: Case report and literature review

Gutiérrez, María López; Espinosa-Rodríguez, Eduardo E; Millán, Juan Martínez San; Urzaiz, Luis Ley; Berrocal, Víctor Rodríguez

doi:10.1016/j.clineuro.2020.105964

Cited by 3 publications

(5 citation statements)

References 40 publications

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“…Historically, infections [ 5 , 18 , [21] , [22] , [23] , [24] ], mostly tuberculous meningitis [ 5 , [25] , [26] , [27] , [28] , [29] ], or myelographies due to the application of an oil-based contrast agent [ 2 , [30] , [31] , [32] , [33] , [34] , [35] ] played a major role as the cause of CSAA. Spinal surgery [ 6 , 11 , 22 , [36] , [37] , [38] , [39] , [40] ] and subarachnoid hemorrhages [ 3 ] continue to play a key role in the development of CSAA. In these cases, CSAA often does not occur until years after the event, whereas after epidural blood patches [ 10 , 13 ] or injection of chemical substances [ 11 , 15 , 16 , 35 , 41 ], CSAA manifests earlier.…”

Section: Discussionmentioning

confidence: 99%

“…In many cases, the diagnosis was made during surgery [ 6 ]. Today, MRI scans are considered the gold standard when diagnosing arachnoiditis [ 3 , 11 , 37 , 48 ]. Anderson et al [ 49 ] described the great variety of MRI findings in 29 cases and CT myelography in seven cases.…”

Section: Discussionmentioning

confidence: 99%

“…Chronic spinal adhesive arachnoiditis (CSAA) is characterized by inflammation and subsequent adhesion of the arachnoid layer, which may lead to progressive myelopathy [ 1 ]. It is usually caused by spinal cord (SC) lesions such as subarachnoid hemorrhages or alterations of the natural anatomic structure of the spine such as from spinal surgery [ [2] , [3] , [4] , [5] , [6] ]. During the course of the disease, cysts and venous congestion may occur with subsequent edema [ [7] , [8] , [9] ], leading to central spinal or radicular symptoms [ 3 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…CSAA remains a disease with limited efficacious options. While in a few cases surgical intervention led to an improvement by cyst fenestration or shunt operation to reduce compression and restore the flow of cerebrospinal fluid and/or venous drainage, in several cases, a progression of adhesions and edema was described [ 3 , 6 ]. CSAA is mainly treated symptomatically with analgesics or physical therapy.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Immunotherapies in chronic adhesive arachnoiditis - A case series and literature review

Hackert¹,

Maßmann²,

Sure

et al. 2021

eNeurologicalSci

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Chronic spinal adhesive arachnoiditis (CSAA) is a rare condition with limited therapeutic options. Surgical treatment proves effective in approximately 60% of cases. Conservative treatment options have not been extensively investigated. Here, we report the course of the disease, analyze the effect of immune treatments in patients with CSAA who were treated in the University Hospital Essen between 2015 and 2020, and conduct a literature review. Three out of four patients showed no improvement after treatment with corticosteroids, methotrexate, or plasmapheresis. All non-responders suffered from CSAA for several years, while one patient who had a disease duration of less than one month fully recovered. It is necessary to verify whether treatment at an early stage of the disease is better than treatment after chronic adhesion manifestation, as it interrupts the development of adhesions and all subsequent complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Immunotherapies in chronic adhesive arachnoiditis - A case series and literature review

Hackert¹,

Maßmann²,

Sure

et al. 2021

eNeurologicalSci

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“…The patient had no risk factor for arachnoiditis, which classifies it as idiopathic and extremely rare (750 people/year worldwide) (Gutiérrez, et al, 2020).…”

Section: Final Commentsmentioning

confidence: 99%

Complete Resolution of Paraparesia by Microlysis Surgery – A Rare Case of Idiopathic Spontaneous Adhesive Arachnoiditis

Chaves,

Neto,

Gonçalves

et al. 2023

JHS

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Objective: To report the case of a patient with spontaneous adhesive arachnoid in T3, associated neurological deficits, its treatment and evolution. Method: Information was obtained through interviews with the patient and his daughter, photographic records of the diagnostic methods to which the patient was submitted, and a review of the literature. Final considerations: The reported case brings up a doubtful surgical treatment of a complex situation in which conservative treatment is the most used and presents an unfavorable outcome. In this case, we achieved a total reversal of the picture. The pathology affects around 750 people a year in the world and, when treated properly, it is able to obtain satisfactory results of the signs and symptoms and a high quality of life back to the patient.

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Considerations for delayed-onset spinal arachnoid web after intracranial subarachnoid hemorrhage

Wong,

Pivazyan,

Breton

et al. 2024

Brain Circulation

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Spinal arachnoid web (AW) is a rare condition causing spinal cord-related issues. Its cause is often idiopathic but can be linked to past trauma or spine surgery. We describe two cases of AWs that developed after subarachnoid hemorrhage (SAH). Case #1 is a 71-year-old male with nonaneurysmal SAH who developed myelopathy 1 year later. Magnetic resonance imaging revealed upper thoracic cord edema and an AW. Case #2 is a 57-year-old female who underwent coiling of a ruptured basilar artery aneurysm and ventriculoperitoneal shunting for hydrocephalus. Twenty months later, she developed mid-thoracic AW requiring surgical resection. Both patients showed symptom improvement postresection avoiding further reoperation. History of SAH is emerging as a risk factor for AW development, emphasizing the importance of monitoring delayed-onset myelopathy and back pain in recent SAH patients.

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Compressive myelopathy secondary to posthemorragic arachnoiditis: Case report and literature review

Cited by 3 publications

References 40 publications

Immunotherapies in chronic adhesive arachnoiditis - A case series and literature review

Immunotherapies in chronic adhesive arachnoiditis - A case series and literature review

Complete Resolution of Paraparesia by Microlysis Surgery – A Rare Case of Idiopathic Spontaneous Adhesive Arachnoiditis

Considerations for delayed-onset spinal arachnoid web after intracranial subarachnoid hemorrhage

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