title: Syringomyelia and arachnoid cysts associated with spinal arachnoiditis following subarachnoid hemorrhage.
abstract: A 66-year-old woman with primary Sjogren syndrome developed syringomyelia following two episodes of subarachnoid hemorrhage (SAH) due to the rupture of basilar artery aneurysms. Gait disturbance and abnormal sensation with pain over the foot and abdomen appeared 3 years after the last SAH. Magnetic resonance (MR) imaging revealed a syringomyelia throughout the thoracic cord, from the T2 to T11 levels. In addition, the thoracic cord was compressed by multiple arachnoid cysts in the ventral side of spinal cord. Computed tomography myelography revealed complete block of cerebrospinal fluid (CSF) flow at the T7 level. Surgery for microlysis of the adhesions and restoration of the CSF flow pathway was performed. Postoperatively, leg motor function slowly improved and she could walk unaided. However, abdominal paresthesia was persisted. Postoperative MR imaging revealed diminished size of the syrinxes. We should recognize syringomyelia and arachnoid cysts due to adhesive arachnoiditis as a late complication of SAH. Microlysis of the adhesions focusing on the lesion thought to be the cause of the symptoms is one of the choices to treat massive syringomyelia and arachnoid cysts associated with arachnoiditis following SAH.
authors.affiliation: Department of Neurosurgery, Nagasaki University, School of Medicine, Sakamoto, Nagasaki, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Ishizaka
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hayashi
authors.forename: Munehiro
authors.initials: M
authors.lastname: Otsuka
authors.forename: Shuji
authors.initials: S
authors.lastname: Fukuda
authors.forename: Keishi
authors.initials: K
authors.lastname: Tsunoda
authors.forename: Ryujiro
authors.initials: R
authors.lastname: Ushijima
authors.forename: Naoki
authors.initials: N
authors.lastname: Kitagawa
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Suyama
authors.forename: Izumi
authors.initials: I
authors.lastname: Nagata
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications / Q000601:surgery / Q000628:therapy; D016080:Arachnoid Cysts / Q000209:etiology* / Q000601:surgery; D001100:Arachnoiditis / Q000134:cerebrospinal fluid / Q000209:etiology*; D003399:Craniotomy; D019299:Decompression, Surgical; D004621:Embolization, Therapeutic; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery / Q000628:therapy; D007796:Laminectomy; D008026:Ligation; D010292:Paresthesia / Q000209:etiology; D012008:Recurrence; D012422:Rupture, Spontaneous; D012859:Sjogren's Syndrome / Q000150:complications; D013117:Spinal Cord Compression / Q000209:etiology; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D013595:Syringomyelia / Q000209:etiology* / Q000601:surgery; D013904:Thoracic Vertebrae; D014549:Urinary Incontinence / Q000209:etiology