Spinal adhesive arachnoiditis mimicking sarcoid myelitis with nodular dural enhancement: A case report

Clark, Grace V.; Silbermann, Elizabeth; Seals, Shannon; Thiessen, Jaclyn; Nesbit, Gary M.; Yadav, Vijayshree; Wooliscroft, Lindsey

doi:10.1016/j.msard.2020.102257

“…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%

“…In six patients, treatment was ineffective [ 11 , [13] , [14] , [15] , [16] ]. Clark et al [ 48 ] described one patient who was treated with corticosteroids because he was initially misdiagnosed with neurosarcoidosis. This treatment initially led to an improvement but over the next 4 years the patient deteriorated.…”

Section: Discussionmentioning

confidence: 99%

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

Hackert¹,

Maßmann²,

Sure

³

et al. 2021

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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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“…Spinal adhesive arachnoiditis (SAA) is defined as collagen deposition in pia matter of arachnoid space due to inflammation caused by various etiologies (1). Trauma, infection, subarachnoid hemorrhage (SAH) and iatrogenic causes such as surgery or epidural/subdural injections are among the most reported causes in literature (1)(2)(3).…”

Section: Introductionmentioning

confidence: 99%

“…Spinal adhesive arachnoiditis (SAA) is defined as collagen deposition in pia matter of arachnoid space due to inflammation caused by various etiologies (1). Trauma, infection, subarachnoid hemorrhage (SAH) and iatrogenic causes such as surgery or epidural/subdural injections are among the most reported causes in literature (1)(2)(3). It has gained various names in the literature like: foramen magnum arachnoiditis (FMA), basal arachnoiditis, hindbrain arachnoiditis, chronic arachnoiditis at the foramen magnum, and arachnoiditis at the craniocervical junction (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

“…It has gained various names in the literature like: foramen magnum arachnoiditis (FMA), basal arachnoiditis, hindbrain arachnoiditis, chronic arachnoiditis at the foramen magnum, and arachnoiditis at the craniocervical junction (3)(4)(5). SAA is associated with different clinical presentations including progressive myelopathy, quadriparesis, spastic gate, syrinx formation, myelopathy and radicular symptoms (1,2,(5)(6)(7)(8). Although numerous theories have been presented, the most agreed and common basis is cerebrospinal fluid (CSF) accumulation distal to its normal passage blockade site in central canal or spinal cord interstitial space (9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

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