Search Our Scientific Publications & Authors

Neurol Sci 2022 Jun 23. Epub 2022 Jun 23.

Department of Microbiology, King George Medical University, Lucknow, Uttar Pradesh, India.

Background: Prospective studies regarding tuberculous myelitis are lacking. We aimed to prospectively evaluate patients with tuberculous myelitis to identify the features that distinguish tuberculous myelitis from other myelitis.

Methods: This was a prospective study. Read More

Cureus 2022 Mar 31;14(3):e23675. Epub 2022 Mar 31.

Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, USA.

Arachnoiditis is a relatively rare condition and can result in long-term chronic and debilitating complications if not diagnosed early and treated properly. However, diagnosis of arachnoiditis is rare and knowledge of potential causes of this condition is still sparse. Current known causes of arachnoiditis include infections, trauma, spinal tumors, and iatrogenic causes induced via neurological interventions. Read More

Eur J Hybrid Imaging 2022 May 3;6(1). Epub 2022 May 3.

Radiology Department, Mater Misericordiae University Hospital, Eccles Street,, Dublin 7, Ireland.

This is a case of high-risk, aggressive, high-grade medullary B-cell lymphoma presenting with new onset of neurological dysfunction following initial complete response to the standard chemoimmunotherapy. A whole-body re-staging PET using fluorodeoxyglucose (F-FDG) integrated with computed tomography (FDG-PET/CT) performed with clinical suspicion of arachnoiditis, eloquently demonstrated unequivocal multifocal FDG uptake by the spinal cord without evidence of systemic recurrence, leading to a clinical diagnosis of secondary CNS lymphoma, which is a rare complication of DLBCL with ominous prognosis. Four cycles of Modified-MATRIX protocol resulted in a halt in fulminant course of the disease and the patient experienced slight reversal of the neurological deficits, although not deemed clinically fit for a repeat FDG-PET/CT due to his poor general well-being. Read More

JA Clin Rep 2022 Apr 12;8(1):28. Epub 2022 Apr 12.

Department of Anesthesia, Kyoto University Hospital, Kyoto City, Japan.

Background: Adhesive arachnoiditis has been described as a deteriorating neurological complication after neuraxial blockade; however, few pieces of literatures have reported minor cases that resemble peripheral neuropathy.

Case Presentation: A 29-year-old nulliparous woman underwent an emergent cesarean delivery under spinal anesthesia at the second and third lumbar interspace (L2/3) without any specific concerns. Subsequently, she developed left L5 and sacral first (S1) radiculopathy that persisted for 2 months. Read More

Drug Discov Ther 2022 May 24;16(2):102-104. Epub 2022 Mar 24.

Department of Medicine, All India Institute of Medical Sciences, Delhi, India.

Myelopathy in central nervous system tuberculosis is notorious for poor outcomes, determined by the severity of inflammation and cord level involved. Acute-onset quadriplegia or paraplegia in these cases represents a neuro-emergency. We report a young female with disseminated tuberculosis who presented with acute onset flaccid quadriparesis with loss of bladder and bowel function. Read More

Eur Spine J 2022 Feb 2. Epub 2022 Feb 2.

Department of Neurosurgery, Ajou University School of Medicine, Suwon, 443-721, Republic of Korea.

Purpose: The 5-year postoperative failure rate of conventional shunt treatment for syringomyelia is 50%, with arachnoditis, shunt obstruction, and shunt malfunction being the most common causes. We report a new syringo-cisterna magna (SCM) shunt that allows syrinx cerebrospinal fluid (CSF) drainage normally into the cerebellomedullary cisterns through the subarachnoid space.

Methods: Between November 2012 and February 2017, six patients (mean age: 57. Read More

Surg Neurol Int 2021 14;12:609. Epub 2021 Dec 14.

Department of Neurosurgery, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India.

Background: Spinal intramedullary tuberculoma (IMT) is a rare manifestation of extrapulmonary tuberculosis (TB). Presentation of TB in the pediatric age group is a significant contributor to mortality.

Case Description: A young vaccinated girl presented to the neurosurgery department with difficulty walking and urinary incontinence. Read More

Oper Neurosurg (Hagerstown) 2022 01;22(1):e58-e61

Department of Neurosurgery, Mie University Hospital, Tsu, Japan.

Background And Importance: The treatment for large central disk herniation (LCDH) at upper lumbar spine is often challenging. Previous reports showed various surgical strategies, such as microdiscectomy with posterior fixation, endoscopic surgery, and microdiscectomy through transdural approach. However, there is no consensus regarding which surgical option is better for LCDH at upper lumbar spine. Read More

Neurology 2022 02 19;98(5):208-213. Epub 2021 Nov 19.

From the Department of Neurology (P.K., L.K., J.M.B.); and Department of Neurosurgery (P.K., J.M.B.), Yale School of Medicine, New Haven, CT; Department of Neurosurgery (P.K., N.T.), Ludwig-Maximilians-University Munich; and Department of Neurology (L.K.), Heidelberg University Hospital, Germany.

A 64-year-old man presented for evaluation of proximally pronounced weakness of the arms with preserved facial and lower extremity strength. Symptoms slowly developed over the last 2 years, and the patient's history was notable for severe meningitis 4 years before presentation, which was adequately treated with antibiotics. On examination, symptoms clinically reassembled man-in-the-barrel syndrome and localized to the cervicothoracic central cord. Read More

Case Rep Neurol 2021 May-Aug;13(2):535-540. Epub 2021 Aug 19.

Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

Arachnoiditis is a rare clinical entity that usually presents with severe debilitating radiating pain that can pose a challenge in diagnosis especially in areas without appropriate imaging modalities. We present a 26-year-old male with progressive lower back pain with radiation to the lower extremities, aggravated by movement and touch. We diagnosed idiopathic arachnoiditis based on cerebrospinal fluid analysis and magnetic resonance imaging. Read More

BMJ Case Rep 2021 Oct 27;14(10). Epub 2021 Oct 27.

Microbiology, Indraprastha Apollo Hospital, New Delhi, India.

Cerebral phaeohyphomycosis refers to central nervous system infection by dematiaceous mould or by dark walled fungi which contain the dark pigment melanin in their cell wall which adds to the virulence of fungus. These dematiaceous fungi can cause a variety of central nervous infections including invasive sinusitis, brain abscess, meningitis, myelitis and arachnoiditis. among these dematiaceous fungi is the most common cause of brain abscess in immunocompetent and immunocompromised individuals and is known to occur worldwide though is predominantly reported from subtropical regions especially the Asian subcontinent. Read More

Joint Bone Spine 2022 03 12;89(2):105291. Epub 2021 Oct 12.

Rheumatology Unit, Hôtel-Dieu, Nantes University Hospital, 1, Place Alexis, 44093 Nantes-Cedex 01, France.

Compression of roots/nerves can disrupt some of their functions, but does not necessarily cause pain. This is illustrated by the frequency of nearly asymptomatic spinal stenosis or disc herniations. In fact, pain of radiculopathies (and nerve entrapments) may mostly be the consequence of intraneural oedema induced by microscopical venous stasis around roots/spinal ganglia (or nerves) not or poorly shown by imaging. Read More

Cureus 2021 Aug 5;13(8):e16910. Epub 2021 Aug 5.

Neurological Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.

Arachnoiditis ossificans (AO) is a rare spinal pathology that develops because of bony metaplasia secondary to chronic inflammation. AO may present with debilitating myelopathy secondary to nerve root compression, making it distinct from spinal calcification commonly seen with aging. AO is extremely rare, having been reported less than 100 times, most commonly in the thoracic spine. Read More

World J Clin Cases 2021 Aug;9(22):6485-6492

Department of Orthopaedics, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.

Background: Hydrocephalus following dural tear after spinal surgery is rare. Although a few cases of obstructive hydrocephalus caused by subdural fluid collection and communicating hydrocephalus associated with meningitis have been reported, the mechanism remains uncertain. Herein we describe a patient complicated with hydrocephalus after cervical laminoplasty in whom subdural fluid collection in the cervical spine and posterior cranial fossa rather than chronic meningitis was the main mechanism. Read More

Asian J Neurosurg 2021 Apr-Jun;16(2):412-417. Epub 2021 May 28.

Department of Radiology, Bumrungrad International Hospital, Bangkok, Thailand.

The authors describe a case of filum terminale arteriovenous fistula (FTAVF) in association with a large L2-L3 disc sequestration and diffuse lumbar arachnoiditis. A 64-year-old male manifested with chronic back pain and gait difficulty. Magnetic resonance imaging (MRI) of the thoracic and lumbosacral spine revealed spinal cord congestion extending from the conus medullaris to the level of T9. Read More

Asian J Neurosurg 2021 Jan-Mar;16(1):204-207. Epub 2021 Feb 23.

Department of Neurosurgery, Annapurna Neurological Institute and Allied Sciences, Maitighar, Kathmandu, Nepal.

Neurocysticercosis (NCC) commonly presents with seizures in developing countries such as Nepal. It may also present with raised intracranial pressure due to obstructive hydrocephalus when cyst is located in the fourth ventricle or foramen of Monro. There are four main stages of NCC (1) Vesicular, (2) Colloidal vesicular, (3) Granular nodular, and (4) Nodular calcified. Read More

eNeurologicalSci 2021 Sep 11;24:100350. Epub 2021 Jun 11.

University Medicine Essen, Department of Neurology, Center for Translational Neuro- and Behavioral Sciences, Hufelandstrasse 55, 45147 Essen, Germany.

Chronic spinal adhesive arachnoiditis (CSAA) is a rare condition with limited therapeutic options. Surgical treatment proves effective in approximately 60% of cases. Conservative treatment options have not been extensively investigated. Read More

Headache 2021 06 11;61(6):974-975. Epub 2021 Jun 11.

Division of Headache and Neuro-Ophthalmology, University of Utah School of Medicine, Salt Lake City, UT, USA.

Biomed Res Int 2021 18;2021:9940001. Epub 2021 May 18.

Directorate of Research, Hospital General de Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico.

Imaging of the postoperative spine requires the identification of several critical points by the radiologist to be written in the medical report: condition of the underlying cortical and cancellous bone, intervertebral disc, and musculoskeletal tissues; location and integrity of surgical implants; evaluation of the success of decompression procedures; delineation of fusion status; and identification of complications. This article presents a pictorial narrative review of the most common findings observed in and postoperative spines. Complications in the spine were grouped in (hematomas, pseudomeningocele, and postoperative spine infection) and findings (arachnoiditis, radiculitis, recurrent disc herniation, spinal stenosis, and textiloma). Read More

Neurology 2021 07 30;97(1):38-39. Epub 2021 Apr 30.

From the Department of Neurosurgery, Bicêtre Hospital, AP-HP, University Paris-Saclay, France.

Acta Neurochir (Wien) 2021 06 21;163(6):1593-1601. Epub 2021 Apr 21.

Department of Neurosurgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan.

Background: It is important to distinguish foramen magnum arachnoiditis (FMA) from Chiari malformation (CM) before surgery because the operative strategies for these diseases differ. In the current study, we compared pretreatment magnetic resonance imaging (MRI) of FMA with CM and investigated the MRI findings useful to differentiate between these diseases.

Methods: We retrospectively reviewed patients with FMA or CM aged ≥ 18 years who underwent surgeries at our institution between 2007 and 2019. Read More

Anaesthesist 2021 06 15;70(6):497-503. Epub 2021 Mar 15.

abcGbR Oberschleißheim, Oberschleißheim, Deutschland.

A 61-year-old woman underwent a tension-free vaginal tape (TVT) operation due to stress incontinence. After technically difficult spinal anesthesia with two attempts the patient developed symptoms of nerve irritation, complained about neckache and headache and showed signs of agitation. The regimen was shifted to general anesthesia and surgery was performed. Read More

J Magn Reson Imaging 2021 09 13;54(3):910-911. Epub 2021 Mar 13.

Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, London, UK.

BMJ Case Rep 2021 Mar 5;14(3). Epub 2021 Mar 5.

General Medicine Bishop Auckland General Hospital, County Durham and Darlington NHS Foundation Trust, Bishop Auckland, UK.

A woman in her 70s presented to the emergency department with fever, fluctuating cognition and headache. A detailed examination revealed neurological weakness to the lower limbs with atonia and areflexia, leading to a diagnosis of bacterial meningitis, alongside a concurrent COVID-19 infection. The patient required critical care escalation for respiratory support. Read More

J Magn Reson Imaging 2021 09 28;54(3):904-909. Epub 2021 Feb 28.

Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon.

Background: Prior imaging studies characterizing lumbar arachnoiditis have been based on small sample numbers and have reported inconsistent results.

Purpose: To review the different imaging patterns of lumbosacral arachnoiditis, their significance, and clinical implications.

Study Type: Retrospective. Read More

eNeurologicalSci 2021 Mar 22;22:100316. Epub 2021 Jan 22.

Department of Radiodiagnosis, St. John's Medical College Hospital, Sarjapur Road, Koramangala, Bangalore 560034, India.

This article aims to familiarize the reader with the MR imaging findings of tubercular radiculomyelitis (TBRM) and to identify the sources of infection. We evaluated 29 patients on a 1.5 T GE MRI in a cross-sectional study. Read More

World Neurosurg 2021 05 16;149:64-66. Epub 2021 Feb 16.

Department of Neurosurgery, Ghent University Hospital, Belgium.

We present a case of a progressive symptomatic intramedullary cyst, diagnosed decades after Lipiodol injection. Lipiodol was originally administered intrathecally for the radiologic diagnosis of spinal masses. A link between the lesion and the history of Lipiodol injection was never suspected. Read More

Headache 2021 02 13;61(2):244-252. Epub 2021 Feb 13.

Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA.

Objective: To report a case of arachnoiditis as a complication of epidural blood patch procedures and to systematically review the diagnostic workup, clinical outcomes, and treatment modalities reported in the literature.

Background: Epidural blood patching is an effective treatment for low-pressure headache secondary to spontaneous cerebrospinal fluid leak or iatrogenic post-dural puncture. Spontaneous intracranial hypotension is believed to be a rare headache disorder, but recently has been diagnosed at higher frequencies, making it an important differential diagnosis for intractable headaches. Read More

Zh Vopr Neirokhir Im N N Burdenko 2021 ;85(1):10-18

Pirogov Russian National Research Medical University, Moscow, Russia.

One of the causes of syringomyelia is arachnopathy following an infectious or non-infectious inflammation of the arachnoid membrane. It is extremely rare that adhesive arachnoiditis develops within the occipital cistern and impairs cerebrospinal fluid flow from the foramen of Magendie, along posterior cerebellar surface and into spinal subarachnoid space. These process result syringomyelia. Read More

Continuum (Minneap Minn) 2021 02;27(1):163-184

Purpose Of Review: This article highlights both common structural causes of myelopathy, such as spondylotic disease, and infrequent but treatable causes, such as syringomyelia, spinal cord herniation, arachnoid cyst, arachnoid band and web, epidural lipomatosis, Hirayama disease, and arachnoiditis.

Recent Findings: Neuroimaging improvements and availability have uncovered many structural abnormalities in the spines and spinal cords of patients who were asymptomatic or minimally symptomatic. Recent published clinical series have improved our knowledge of the natural history of structural abnormalities and the risks of intervention versus conservative management. Read More