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J Neurol Surg Rep 2014; 75(01): e56-e61
DOI: 10.1055/s-0033-1363506
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Compressive Cervicothoracic Adhesive Arachnoiditis following Aneurysmal Subarachnoid Hemorrhage: A Case Report and Literature Review

Gazanfar Rahmathulla
1   Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida
2   Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio, United States
,
Kambiz Kamian
2   Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio, United States
› Author Affiliations
Further Information

Publication History

01 September 2013

03 November 2013

Publication Date:
16 January 2014 (online)

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Abstract

We present the case of a 55-year-old woman with diffuse adhesive arachnoiditis in the posterior fossa and cervicothoracic spine following posterior inferior cerebellar artery aneurysmal subarachnoid hemorrhage (SAH). She underwent aneurysm clipping with subsequent gradual neurologic decline associated with sensory disturbances, gait ataxia, and spastic paraparesis. Magnetic resonance imaging revealed diffuse adhesive arachnoiditis in the posterior fossa and cervicothoracic spine, syringobulbia, and multiple arachnoid cysts in the cervicothoracic spine along with syringohydromyelia. Early surgical intervention with microlysis of the adhesions and duraplasty at the clinically relevant levels resulted in clinical improvement. Although adhesive arachnoiditis, secondary arachnoid cysts, and cerebrospinal fluid flow abnormalities resulting in syrinx are rare following aneurysmal SAH, early recognition and appropriate intervention lead to good clinical outcomes.

Keywords

aneurysmal subarachnoid hemorrhage - adhesive arachnoiditis - arachnoid cysts - syringohydromyelia - syringobulbia
 

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