Management of syringomyelia associated with tuberculous meningitis: A case report and systematic review of the literature

Kannapadi, Nivedha; Alomari, Safwan; Caturegli, Giorgio; Bydon, Ali; Cho, Sung Min

doi:10.1016/j.jocn.2021.01.052

Cited by 4 publications

(6 citation statements)

References 12 publications

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“…When caused by adhesive arachnoiditis, the incidence is 2–4 cases/100,000 population[ 34 ] while it is estimated that around 1–2% of patients with active tuberculous meningitis will go on to develop syringomyelia. [ 17 , 34 ] A number of cases of infectious spinal arachnoiditis progressing to syringomyelia have been reported in the literature including those involving Pott’s disease, Listeria monocytogenes meningoencephalitis, tuberculous arachnoiditis, and Candida tropicalis spinal arachnoiditis. [ 11 , 12 , 14 , 15 , 17 , 18 , 23 , 26 ] Interestingly, the direct association between syringomyelia and arachnoiditis is relatively rare as compared to the association of both arachnoiditis and syringomyelia with Chiari malformation, suggesting that the two may also be indirectly related through an underlying anatomical deformity.…”

Section: Review Of Literaturementioning

confidence: 99%

“…Kannapadi et al . [ 17 ] reviewed literature around the treatment of syringomyelia associated with tuberculous arachnoiditis. They provide a comparison between medical versus surgical intervention.…”

Section: Review Of Literaturementioning

confidence: 99%

“…It is plausible the caregivers chose to surgically intervene or not based on how much benefit each patient could potentially get from surgery. [ 17 ]…”

Section: Review Of Literaturementioning

confidence: 99%

“…[17,34] A number of cases of infectious spinal arachnoiditis progressing to syringomyelia have been reported in the literature including those involving Pott's disease, Listeria monocytogenes meningoencephalitis, tuberculous arachnoiditis, and Candida tropicalis spinal arachnoiditis. [11,12,14,15,17,18,23,26] Interestingly, the direct association between syringomyelia and arachnoiditis is relatively rare as compared to the association of both arachnoiditis and syringomyelia with Chiari malformation, suggesting that the two may also be indirectly related through an underlying anatomical deformity. [8,20,29] Caplan et al presented a five patients case series of patients with arachnoiditis who went on to develop syringomyelia.…”

Section: Introductionmentioning

confidence: 99%

“…It is plausible the caregivers chose to surgically intervene or not based on how much benefit each patient could potentially get from surgery. [17] Naito et al provided a retrospective analysis of the safety and efficacy of syringoperitoneal shunting in patients with syringomyelia secondary to spinal adhesive arachnoiditis. Average functionality (measured using the modified McCormick functional schema) was preserved at 4.8 at the most recent follow-up visit (compared to 4.7 preoperatively) while there was significant improvement in pain (measured using the sensory pain scale), which reduced from 2.9 preoperatively to 2.5 at the most recent follow-up visit.…”

Section: Introductionmentioning

confidence: 99%

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Spinal arachnoiditis and syringomyelia: Review of literature with emphasis on postinfectious inflammation and treatment

Nadeem

Baig

Tariq

et al. 2022

Surgical Neurology International

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Background: Arachnoiditis refers to chronic inflammation of the arachnoid mater and subarachnoid space due to three major etiologies: chemical, mechanical, and postinfectious. As a rare disease with variable symptomatology and severity at presentation, arachnoiditis can be extremely debilitating with many complications, prominent among which is syringomyelia. Methods: We reviewed current literature concerning postinfectious spinal arachnoiditis and associated syringomyelia with emphasis on the treatment options that have been used to date and discuss their respective benefits and drawbacks. Results: It is critical to understand the natural history and potential complications of patient with postinfectious arachnoiditis. Surgical and medical treatments both have their own merits and demerits. Different surgical approaches have been employed with variable success rates. Conclusion: At present, no consensus exists regarding management of these patients due to the variable nature of the disease that affects treatment efficacy; however, surgical intervention in selected cases may be beneficial.

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Section: Review Of Literaturementioning

confidence: 99%

Section: Review Of Literaturementioning

confidence: 99%

“…It is plausible the caregivers chose to surgically intervene or not based on how much benefit each patient could potentially get from surgery. [ 17 ]…”

Section: Review Of Literaturementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Spinal arachnoiditis and syringomyelia: Review of literature with emphasis on postinfectious inflammation and treatment

Nadeem

Baig

Tariq

et al. 2022

Surgical Neurology International

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Surgery for Central Nervous System Tuberculosis in Children

Muzumdar,

Bansal,

Rai

et al. 2024

Advances and Technical Standards in Neurosurgery

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Delayed spinal arachnoiditis with syringomyelia following aneurysmal subarachnoid haemorrhage: a case report with patient experience

Jain,

Jaunozolina,

Putraima

et al. 2024

Spinal Cord Ser Cases

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Background and importance Syringomyelia, or the formation of fluid-filled cysts within the spinal cord, associated with delayed spinal arachnoiditis is an uncommon complication of aneurysmal subarachnoid haemorrhage. To date, about 18 cases have been reported in medical literature, with just two reported in patients under the age of 35 years. Clinical presentation A 27-year-old female patient complained of sudden, severe headaches in the occipital region, nuchal rigidity, and drowsiness when she presented at our institution. A head computed tomography scan revealed intraventricular bleeding in the lateral and fourth ventricles with more extensive haemorrhaging in the frontal horns. A left posterior inferior cerebellar artery (PICA) aneurysm was confirmed via digital subtraction angiogram, and endovascular embolization was done. Two years later, the patient reported intense pain in the lower back along with symptoms suggestive of spinal cord compression. Spinal magnetic resonance imaging (MRI) showed spinal adhesions from C1 to L4, syringomyelia with some vasogenic oedema extending from T3 to T9 level, and a cyst in the lumbar region. Consequently, a right hemilaminectomy was performed along with microsurgical release of arachnoid adhesions and placement of a subdural drain. Radiological and symptomatic improvements were observed. Since then, the patient’s clinical condition has remained stable during the past three years of follow-up visits. Conclusions Literature on optimal treatment modalities and patient prognosis is scarce and debated. The time for symptom improvement depends on the level and extent of spinal cord involvement. Rehabilitation may be required for most patients, as complete symptomatic recovery may not be attainable.

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Management of syringomyelia associated with tuberculous meningitis: A case report and systematic review of the literature

Cited by 4 publications

References 12 publications

Spinal arachnoiditis and syringomyelia: Review of literature with emphasis on postinfectious inflammation and treatment

Spinal arachnoiditis and syringomyelia: Review of literature with emphasis on postinfectious inflammation and treatment

Surgery for Central Nervous System Tuberculosis in Children

Delayed spinal arachnoiditis with syringomyelia following aneurysmal subarachnoid haemorrhage: a case report with patient experience

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