Intramedullary Cavitation Resulting From Adhesive Spinal Arachnoiditis

Experimental Syringohydromyelia Induced by Adhesive Arachnoiditis in the Rabbit: Changes in the Blood–Spinal Cord Barrier, Neuroinflammatory Foci, and Syrinx Formation

“…However, the pathogenic significance of arachnoid scarring had not been as generally acknowledged, although most authors report arachnoid adhesions at the level of the spinal injury in patients with post-traumatic syringomyelia (Barnett et al, 1973;Caplan et al, 1990;Edgar and Quail, 1994;Holmes, 1915;McLean et al, 1973;Oakley et al, 1981;Padilla, 1982;Rossier et al, 1981;Seibert et al, 1981). Spinal arachnoiditis may also be caused by pyogenic infection (Barnett et al, 1973;Jenik et al, 1981), tuberculous meningitis (Barnett et al, 1973;Brooks et al, 1954;Feigin et al, 1971;Gimenez-Roldan et al, 1974;Jenik et al, 1981), luetic meningitis (Barnett et al, 1973), bleeding into the meninges (Feigin et al, 1971;Nelson, 1943), and post-operative scarring (Barnett et al, 1973). Through spinal arachnoiditis is known to be associated with syrinx formation, the mechanism of syringomyelia is not well understood.…”

“…There are many histopathological descriptions of the spinal cord tissue of syringomyelia in the literature of autopsy (Hinokuma et al, 1992;Lubin, 1940;Milhorat et al, 1995;Nelson, 1943;Netsky, 1953;Vinters, 1991), and experimental models (Blagodatsky et al, 1990;Camus and Roussy, 1914;Feigin et al, 1971;Hall et al, 1975Hall et al, ,1980McLaurin et al, 1954;Milhorat et al, 1993;Rascher et al, 1987;Tatara, 1992;Williams and Bentley, 1980;Williams and Weller, 1973); however, there has been very little experimental work on spinal arachnoiditis and syringomyelia done with scanning electron microscopy (SEM; Hall et al, 1977;Rascher et al, 1987;Reddy et al, 1989), and transmission electron microscopy (TEM; Chakrabortty et al, 1994Chakrabortty et al, ,1997Reddy et al, 1989). The development of myelopathy in patients with syringomyelia is thought to be closely related to intramedullary edema resulting from the formation of the syrinx; however, there has been very little experimental work done on the permeability of blood vessels in the spinal cord with intramedullary edema (Chakrabortty et al, 1997;Stoodley et al, 1999).…”

Arachnoiditis ossificans associated with syringomyelia: An unusual cause of myelopathy

“…However, arachnoiditis ossificans (AO) is a unique and uncommon phenomenon characterized by intrathecal bony metaplasia of the arachnoid membrane 1. This pathology develops following numerous predisposing processes including surgery, trauma, infection, myelography and subarachnoid hemorrhage 2,3,4. As of yet, the pathophysiology of AO is unknown; however, it may be a result of chronic inflammation of the arachnoid 5…”

Non-traumatic adhesive arachnoiditis as a cause of spinal cord syndromes. Investigation on 507 patients

“…In cases of cavitation with underlying adhesive arach noiditis a circulatory impairment of the spinal cord was considered as a possible pathogenetic mechanism. A greater role than that of thickening of the vessel walls causing diminution of the blood supply (Tauber & Langworthy, 1935;Lubin, 1940;McLaurin et al, 1954), may be played by impaired venous drainage (venostasis) from the cord with resulting ischaemia (Stevenson, cited by Nelson, 1943)· Appleby et al (1969) postulated an association between hydromyelia and adhesive arachnoiditis around the outflow foramina of the 4th ventricle and generally at the foramen magnum to be caused by Gardner's (1965) hydrodynamic mechanism (pulsatile CSF pressure from the ventricular system into central canal -communicating syringomyelia).…”