Surgical Management of Syringomyelia Associated with Spinal Adhesive Arachnoiditis, a Late Complication of Tuberculous Meningitis: A Case Report

Abstract

Syringomyelia associated with tuberculous meningitis is an extremely rare condition. Only a few studies have reported clinical experience with syringomyelia as a late complication of tuberculous meningitis. Twenty-six years after a tuberculous meningitis episode, a 44-year-old man presented with progressively worsening spastic paresis of the lower limbs and impaired urinary function for 2 years. Radiological examination revealed syringomyelia extending from the level of C2 to T9 and arachnoiditis with atrophy of the spinal cord between C2 and T3. We performed laminectomy from C7 to T1, dissected the arachnoid adhesion and placed a syringo-pleural shunt via keyhole myelotomy. One year after the operation, his neurological condition improved. The postoperative control magnetic resonance imaging revealed the correctly located shunt and significantly diminished syringomyelia cavities. We aim to discuss the mechanism of syrinx formation following tuberculous meningitis and to share our surgical therapeutic experience with this rare disease entity.

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

“…Furthermore, sporadic cases with no remarkable history explaining CSAA have been reported (3.6%) [ 4 , 19 , 20 ]. 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.…”

An Atypical Clinical Presentation of Post-traumatic Syringomyelia: A Case Report and Brief Review of the Literature

“…Lastly, our patient also had multiple episodes of meningitis in the following years after the spinal trauma. Meningitis is reported to cause spinal adhesive arachnoiditis and can lead to the formation of a syrinx due to the disruption of CSF flow [ 9 ]. However, in our case, meningitis was ruled out as the cause of syringomyelia due to the absence of any significant adhesive arachnoiditis in the MRI.…”