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Intracranial haematomas
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
Other features present include indentation of the brain with or without midline shift. This is often severe in well-developed cases. There may be discolouration of the underlying arachnoid. Associated conditions include atrophy, related to age, dementia or alcohol, as well as other pathologies such as old cerebral infarction or previous head injury.
Hunter disease/mucopolysaccharidosis type II/iduronate sulfatase deficiency
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
Hearing loss is regularly observed. Retinal dysfunction may be documented by electroretinography [35]. Chronic papilledema has been reported in the absence of increased intracranial pressure [36, 37]. Hydrocephalus appears to be rare in the mild forms of Hunter disease [28]. Arachnoid cysts have been observed [38]. Spinal stenosis, especially cervical may cause cord compression [39].
The Nervous System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Inflammation of the spinal meninges is called spinal meningitis, Caused by either a viral or bacterial infection of the meninges, particularly the arachnoid and pia mater, the inflammation increases the amount of cerebrospinal fluid and changes its composition, resulting in the symptoms. The first sign is usually headache, fever, chills, and vomiting; neck rigidity, changes in reflexes, and back spasms are common. Diagnosis is usually made by examination of cerebrospinal fluid collected by lumbar puncture, and antibiotic therapy for the etiologic organism is primary in treatment.
Spinal arachnoiditis leading to recurrent reversible myelopathy: A case report
Published in The Journal of Spinal Cord Medicine, 2022
Erol Jahja, Charles Sansur, Peter Howard Gorman
The pathogenesis of arachnoiditis is thought to be the result of a noxious insult to the pia-arachnoid matter causing inflammation followed by adhesion formation. The initial inflammation stage can lead to nerve root swelling, which can manifest into radicular symptoms. As this process continues, there is tethering of the nerve roots and spinal cord. With disorganized conglomeration, CSF flow can be disrupted, which can cause a mixture of complications, including ischemia, demyelination, cavitation and syringomyelia at the level of disrupted CSF flow.7 With adhesion and cyst formation, the disease process becomes more chronic as symptoms become persistent.5 In our case, the sudden waxing and waning nature of the symptoms could be attributed to temporary release of spinal fluid during lumbar puncture and sudden aggressive motion as would occur during a fall. Although the incidence is uncertain, prior reports have noted that inflammatory reactions such as arachnoiditis can result in intrathecal scarring, impeding subarachnoid CSF pathways.7 No animal models exist to support the pathophysiologic hypothesis, but a rat model linking post-traumatic arachnoiditis to increased CSF flow from perivascular spaces as the cause of syrinx expansion does exist and supports a relationship between trauma and CSF flow changes.8 Surgical lysis of adhesions in the subarachnoid space with expansile duraplasty is a well-established technique to treat impaired CSF flow around the spinal cord in patients with post-traumatic syringomyelia.9
Arachnoiditis ossificans associated with syringomyelia: a case report
Published in British Journal of Neurosurgery, 2019
Changbing Wang, Zhong Chen, Deyong Song, Tianhang Xuan
The management of arachnoidits ossificans remains a dilemma between conservative and surgical treatment. For those patients with mild symptoms, close observation should be adopted. In patients with severe or deteriorating symptoms, surgery is often justified. The aim of surgery for treating arachnoiditis ossifications is decompression of the neural elements. However, the reported surgical result of arachnoiditis ossifications is gernerally poor. Only half of the patients managed with surgical intervention showed improvement in the literature. Because there is a paucity of reports of arachnoiditis ossifications with syringomyelia, the standard of care has not been established. Laminectomy and decompression with or without syrinx drainage and shunting remain the major surgical techniques. Controversy exists regarding the need for drainage and shunting of the syrinx. Further research to identify the pathophysiology of arachnoid ossification with syringomyelia may help find an optimum treatment.
Ruptured intra-cranial arachnoid cysts: a case series from a single UK institution
Published in British Journal of Neurosurgery, 2021
Samuel Hall, Alexander Smedley, Susruta Manivannan, Nijaguna Mathad, Ryan Waters, Aabir Chakraborty, Owen C. Sparrow, Vassilios Tsitouras
Arachnoid cysts (AC) are benign fluid-filled structures that are anatomically associated with the arachnoid mater.1 Though AC are commonly identified in the middle cranial fossa, they can develop anywhere throughout the neural axis.1 The diagnosis of incidental AC is becoming more common owing to the availability of cross-sectional imaging, but its underlying aetiology remains unclear. Explanations for underlying mechanism of formation include developmental abnormalities secondary to splitting or duplication of the arachnoid membrane2 and trauma-induced formation of AC.3,4 The prevalence of AC in adults has been reported as 1.4%,5 whilst a lower incidence of 0.4% has been reported in children.6