| A five-year-old boy presented with tuberculous meningitis and subsequently developed amaurosis with optochiasmatic arachnoiditis (OCA) late in the convalescent stage of the illness. The visual evoked cortical potentials were correlated with the decreased and improved postoperative acuity. The diagnosis and classification of OCA have been discussed with emphasis given to prompt neurosurgical treatment. ( info) |
| arachnoiditis ossificans (AO) is a rare entity in which ossification of the leptomeninges occurs. This report illustrates a patient with AO of the cervical and dorsal spine, diagnosed by helical computed tomography with multiplanar reconstruction. It demonstrates the value of computed tomography in diagnosing calcified plaques and the utility of multiplanar reconstruction in giving an exact anatomic reference to neurosurgeon. ( info) |
3/155. The effect of Lipo prostaglandin E1 on cauda equina blood flow in patients with lumbar spinal canal stenosis: myeloscopic observation. STUDY DESIGN: Myeloscopic examination was performed to observe the cauda equina in patients with lumbar spinal canal stenosis before and after treatment with Lipo prostaglandin E1, a strong peripheral vasodilator. OBJECTIVES: The purpose of this study was to clarify the effects of Lipo prostaglandin E1 on blood flow in the cauda equina in patients with lumbar spinal canal stenosis. SETTING: japan, Kagoshima methods: We performed myeloscopic observations of morphological changes in blood vessels running along the cauda equina in 11 patients with lumbar spinal canal stenosis before and after treatment with Lipo prostaglandin E1. RESULTS: In six of these patients, dilation of the running blood vessels was observed immediately after administration. In all of the patients who exhibited a dilation of vessels on the surface of the cauda equina, intermittent claudication and lower extremity pain and/or numbness lessened immediately after examination. However, none of the patients who exhibited no morphological changes in the vessels along the cauda equina after administration of Lipo prostaglandin E1 experienced any improvement of symptoms at the time of examination. CONCLUSION: Results of this study suggest that Lipo prostaglandin E1 may enhance blood flow in the cauda equina and improve clinical symptoms in some patients with lumbar spinal stenosis. ( info) |
| We present the radiological features of a 42-year-old man with long-standing inactive ankylosing spondylitis (AS), demonstrating that arachnoiditis is a cause of a cauda equina syndrome (CES) in this disease. CT showed a dorsal arachnoid diverticulum causing scalloped erosion of the laminae, and punctate and curvilinear dural calcification. MRI revealed adhesion and convergence of the cauda equina dorsally into the arachnoid pouch, causing the dural sac to appear empty canal. To the best of our knowledge, dural calcification on CT is a new finding in AS, which may be related to the CES. Our findings support the hypothesis that chronic adhesive arachnoiditis with subsequent loss of meningeal elasticity may be the main cause of CES in AS. ( info) |
5/155. Neonatal escherichia coli meningitis: spinal adhesions as a late complication. We describe two boys who had severe spinal complications in adolescence after a favorable initial recovery from neonatal escherichia coli meningitis. Due to spinal granulomatous adhesions, one boy died after an attempted scoliosis operation (high cord lesion). The other showed severe progressive neurological deterioration with spinal and cerebellar symptoms.Conclusion The severe complication of chronic arachnoiditis with spinal adhesion may occur many years after neonatal acute bacterial meningitis. ( info) |
6/155. Magnetic resonance appearance of multiple intracranial epidermoid cysts: intrathecal seeding of the cysts? Case report. A 44-year-old man presented to the hospital with multiple intracranial epidermoid cysts. The clinical manifestations of his disease included chronic headaches and one seizurelike episode. Findings determined by magnetic resonance (MR) imaging, surgery, and histological analysis indicated intrathecal and intraventricular seeding of the cysts. Spontaneous (nontraumatic) seeding of multiple daughter cysts from intracranial epidermoid cysts is still very rare and their multiple appearances on MR imaging should be distinguished from the simple scattering of oily contents due to cyst rupture. ( info) |
| A 62-year-old male presented with progressive quadriparesis. magnetic resonance imaging of the spine revealed a spinal cord syrinx but failed to detect extensive arachnoiditis ossificans noted on insertion of a syringopleural shunt. A postoperative computed tomography scan clearly demonstrated the abnormality and its extent. We present a rare case of syringomyelia resulting from spinal arachnoiditis ossificans and review the relevant literature. ( info) |
8/155. Spinal arachnoiditis following subarachnoid haemorrhage: report of two cases and review of the literature. Two patients with spinal arachnoiditis following subarachnoid haemorrhage are described. A complete spinal block was seen at the mid thoracic level with characteristics of spinal arachnoiditis. Only one patient had severe symptoms. Both patients were treated conservatively. signs and symptoms diminished in time. A review of the literature is given and the aetiology is discussed. ( info) |
9/155. Familial spinal arachnoiditis with secondary syringomyelia: clinical studies and MRI findings. We report the clinical and MRI findings of two patients with familial spinal arachnoiditis. Although their initial symptoms were various, they both showed spastic paraparesis and sensory disturbance below the thoracic level. cytokines and WBC in the CSF were studied, but they were not elevated at all. The spinal magnetic resonance images of each showed extensive arachnoiditis and a cystic structure. The other impressive features included: (i) an enhancement within the thickened arachnoid and an adhesion between the spinal cord and the dura mater, (ii) deformation of the thoracic cord where the arachnoid adhered, and (iii) secondary syrinx formation. laminectomy may have an adverse outcome for such patients. ( info) |
| This is the first report of a patient with venous insufficiency following compressive arachnoiditis ossificans (AO). Symptoms of fluctuating monoplegia and sensory disturbance appeared monthly, lasting several weeks each time. Spinal magnetic resonance imaging (MRI) showed high T2-weighted signal intensity in the posterior portion of the column from T11 to T12 and an intradural lesion with low T2-weighted signal intensity. Neurological function and MRI improved markedly following an operation on AO. The symptoms seen in the present case were due to posterior venous insufficiency following compressive AO. ( info) |