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Headache 2021 Jun 11. 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

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

J Magn Reson Imaging 2021 Mar 13. 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 Feb 28. 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

Headache 2021 Feb 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

World Neurosurg 2021 Apr 27;148:116-117. Epub 2021 Jan 27.

Department of Neurosurgery, Mohamed the VIth University Hospital Center of Marrakech, Marrakech, Morocco; Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco.

Arachnoiditis ossificans of the spine is a rare entity defined as an ossification of the leptomeninges resulting in neurologic decline. We describe the case of a 42-year-old woman, without any obvious predisposing factor, who presented with a progressive cauda equina syndrome. The imaging findings on magnetic resonance imaging were confusing by showing an atypical intraspinal lesion extending from L1 to S1. Read More

Cureus 2020 Dec 23;12(12):e12241. Epub 2020 Dec 23.

Neurology, Rush University Medical Center, Chicago, USA.

This report describes a case of subarachnoid hemorrhage complicated by ventriculitis and subsequent delayed cerebral vasospasm, severe chronic spinal arachnoiditis, and Froin syndrome. A 60-year-old woman presented with diffuse aneurysmal subarachnoid hemorrhage and underwent successful coil embolization of ruptured left anterior cerebral artery aneurysm. Her course was complicated by bacterial ventriculitis and acute hydrocephalus necessitating ventriculoperitoneal shunt placement. Read More

World Neurosurg 2021 Feb 22;146:362. Epub 2020 Oct 22.

Neurosurgery Department, Centre Hospitalier Universitaire Grenoble Alpes (CHUGA), Grenoble, France; Université de Grenoble Alpes, Grenoble, France; Laboratoire d'Anatomie des Alpes Françaises (LADAF), Université de Grenoble Alpes, Grenoble, France.

Premature infants with severe germinal matrix intraventricular hemorrhage (IVH) are at high risk of posthemorrhagic ventricular dilation and hydrocephalus (Video 1). We report the case of a 3-month-old premature infant referred for posthemorrhagic multilocated hydrocephalus. He presented with somnolence, hypotonia, and a bulging fontanelle. Read More

Asian J Neurosurg 2020 Jul-Sep;15(3):527-531. Epub 2020 Aug 28.

Department of Neurosurgery, PGIMS, Rohtak, Haryana, India.

Introduction: An intraventricular cysticercus cyst is observed in 7%-30% patients of neurocysticercosis (NCC). Apart from causing arachnoiditis, intraventricular NCC (IVNCC) can cause sudden death due to acute episodes of hydrocephalus. Various treatment modalities available are external cerebrospinal fluid (CSF) diversion, microsurgical removal, and endoscopic management. Read More

Acta Neurochir (Wien) 2021 01 18;163(1):227-228. Epub 2020 Sep 18.

Department of Neurosurgery, Royal Infirmary of Edinburgh, Little France, Edinburgh, EH16 4SA, UK.

Int J Surg Case Rep 2020 29;74:273-276. Epub 2020 Aug 29.

Department of Orthopaedic Surgery, Seoul Spine Institute, Sanggyepaik Hospital, College of Medicine, Inje University, Republic of Korea.

Background: Adhesive arachnoiditis is an uncommon lesion caused by an inflammatory reaction in spinal nerves. Reports of substantial symptomatic thoracolumbar (TL) adhesive arachnoiditis after spinal surgery are rare. To the best of our knowledge, this is the first presentation of delayed adhesive arachnoiditis with cauda equina syndrome after decompression and fusion for a traumatic TL flexion-distraction injury. Read More

Korean J Radiol 2021 02 28;22(2):225-232. Epub 2020 Aug 28.

Department of Neurosurgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.

Objective: To determine whether changes in the transiting nerve rootlet or its surroundings, as seen on MRI performed after lumbar hemilaminectomy, are associated with persistent postoperative pain (PPP), commonly known as the failed back surgery syndrome.

Materials And Methods: Seventy-three patients (mean age, 61 years; 43 males and 30 females) who underwent single-level partial hemilaminectomy of the lumbar spine without postoperative complications or other level spinal abnormalities between January 2010 and December 2018 were enrolled. Two musculoskeletal radiologists evaluated transiting nerve rootlet abnormalities (thickening, signal alteration, distinction, and displacement), epidural fibrosis, and intrathecal arachnoiditis on MRI obtained one year after the operations. Read More

World Neurosurg 2021 01 2;145:13-18. Epub 2020 Sep 2.

Department of Neurosurgery, Nagoya University Hospital, Nagoya, Japan.

Background: Spinal myxopapillary ependymoma (SME), generally considered a benign entity, can exhibit brain and whole-spine metastases as well as local recurrence after surgery. However, the presence of preoperative retrograde intracranial dissemination at the time of diagnosis is very rare.

Case Description: We report a case of SME in a 22-year-old man who presented with acute exacerbation of chronic back pain shooting down both thighs and weakness in both legs. Read More

Curr Opin Infect Dis 2020 10;33(5):339-346

Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.

Purpose Of Review: Subarachnoid neurocysticercosis (SUBNCC) is caused by a morphologically unique proliferative form of Taenia solium involving the subarachnoid spaces. Prolonged therapy based upon the pathophysiology of SUBNCC and long-term follow-up have shed light on the course of disease and led to highly improved outcomes.

Recent Findings: SUBNCC has a prolonged incubation period of between 10 and 25 years characterized by cyst proliferation and growth and invasion of contiguous spaces leading to mass effect (Stage 1). Read More

Acta Neurol Belg 2021 Feb 24;121(1):47-53. Epub 2020 Aug 24.

Department of Neurology, University Hospital, Zielona Góra, Poland.

Spinal adhesive arachnoiditis is a rare pathology involving pia mater of the spinal cord and nerve roots. It can potentially lead to disability-many patients end up wheelchair-bound due to subsequent paraparesis. It is an infrequent but possible cause of lower extremities weakness in patients with a history of spinal surgery, epidural anaesthesia, myelography or spinal tumors. Read More

Cureus 2020 Jul 20;12(7):e9304. Epub 2020 Jul 20.

Pathology, Texas Tech University Health Sciences Center, Lubbock, USA.

Spinal coccidioidomycosis is a rare disseminated form of coccidioidomycosis infection. According to the literature, majority of patients are African American males. We present a rare case of spinal coccidioidomycosis in a young, Caucasian female with coccidioidomycosis meningitis at age 16 years who presented with bilateral lower extremity weakness after antifungal medication lapse for one year. Read More

Rev Neurol (Paris) 2021 May 18;177(5):498-507. Epub 2020 Aug 18.

CHU Caen, Department of Neurosurgery, Avenue de la Côte-de-Nacre, 14000 Caen, France; Université Caen Normandie, Medical School, 14000 Caen, France; INSERM, UMR-S U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), GIP Cyceron, 14000 Caen, France. Electronic address:

Syringomyelia is a rare disorder in which a fluid-filled cyst forms within the spinal cord, resulting in myelopathy. Meanwhile, the abnormal dilatation of the central canal is referred to as hydromyelia or slit-like syrinx. The most prevailing classification is based on anatomical features and pathogeny rather than pathophysiological mechanisms. Read More

World Neurosurg 2020 11 6;143:180-182. Epub 2020 Jul 6.

Department of Neurosurgery, Instituto Nacional de Ciencias Neurológicas, Lima, Perú.

Subarachnoid neurocysticercosis (NCC) is a form of NCC with cysticerci located in the subarachnoid space. This form of NCC can cause general and focal neurologic symptoms, and sometimes requires surgical intervention as a treatment. In this report, we present a rare case of hemifacial spasm secondary to arachnoiditis because of an NCC cyst in the cerebellopontine angle. Read More

Mult Scler Relat Disord 2020 Sep 2;44:102257. Epub 2020 Jun 2.

Department of Neurology, Oregon Health & Science University, Portland, OR, USA; VA Portland Health Care System, Portland, OR, USA. Electronic address:

Spinal adhesive arachnoiditis (SAA) is a rare, but often devastating, cause of compressive myelopathy. We report a patient with SAA resulting in a longitudinally extensive T2-hyperintense spinal cord lesion with initial nodular pial and dural enhancement mimicking neurosarcoidosis. Neurologists should be aware of this entity, especially in patients who have pertinent risk factors, such as prior meningitis, spinal cord trauma, or surgery. Read More

J Clin Neurosci 2020 Aug 4;78:128-134. Epub 2020 Jun 4.

Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Radiology, Mayo Clinic, Rochester MN, USA. Electronic address:

Spinal solitary fibrous tumor/hemangiopericytoma (SFT/HPC) is a rare mesenchymal malignancy. Radiographically, SFT/HPCs have a mutable appearance, with irregular borders, heterogeneous contrast enhancement, and variable but frequently hypointense T2 signal. We report a series of 5 neurosurgically managed spinal SFT/HPCs treated at our institution, with particular attention to 3 lesions demonstrating marked T2-hypointensity and differential diagnosis for the unusual finding of a "T2 dark" spinal lesion. Read More

Ann Clin Transl Neurol 2020 05 7;7(5):865-868. Epub 2020 May 7.

Department of Neurology, The First Hospital of Jilin University, Changchun, China.

Ultrasonographically measured optic nerve sheath diameter measurement has become a common noninvasive approach for detecting elevated intracranial pressure. We present a case of aneurysmal subarachnoid hemorrhage with elevated intracranial pressure. Postoperative arachnoiditis developed, and lumbar puncture revealed low intracranial pressure. Read More

Am J Trop Med Hyg 2020 08 23;103(2):713-718. Epub 2020 Apr 23.

Division of Infectious Diseases, Olive View - UCLA Medical Center, Sylmar, California.

Clinical worsening or new manifestation of cryptococcal disease following initiation of anti-retroviral therapy (ART) in an HIV patient is a hallmark of cryptococcal immune reconstitution inflammatory syndrome (C-IRIS). However, it can be difficult to distinguish IRIS from worsening or new infection. Here, we present a case of severe C-IRIS involving multiple cerebellar, spinal, and intradural abscesses and spinal arachnoiditis 7 months after ART initiation in an AIDS patient with uncertain prior ART compliance. Read More

Clin Neurol Neurosurg 2020 07 10;194:105835. Epub 2020 Apr 10.

Neurosurgery Department, Tulane/Ochsner Medical Centers, LA, USA. Electronic address:

Spinal adhesive arachnoiditis (SAA) with cyst formation secondary to infectious meningitis is a rare clinical entity. These cysts can compress the spinal cord and cause neurologic decline. We present a case of a patient who underwent resection for an intradural schwannoma which was complicated post-operatively by bacterial meningitis and development of several recurrent thoracic arachnoid cysts. Read More

PLoS One 2020 19;15(3):e0226584. Epub 2020 Mar 19.

Centers for Personalized Diagnostics and Immunotherapy, Vaccines and Virotherapy, Biodesign Institute, Arizona State University, Tempe, Arizona, United States of America.

The pathogenesis of spinal cord injury (SCI) remains poorly understood and treatment remains limited. Emerging evidence indicates that post-SCI inflammation is severe but the role of reactive astrogliosis not well understood given its implication in ongoing inflammation as damaging or neuroprotective. We have completed an extensive systematic study with MRI, histopathology, proteomics and ELISA analyses designed to further define the severe protracted and damaging inflammation after SCI in a rat model. Read More

Fluids Barriers CNS 2020 Feb 29;17(1):11. Epub 2020 Feb 29.

Faculty of Medicine and Health Sciences, 2 Technology Place, Macquarie University, Sydney, NSW, 2109, Australia.

Background: Syringomyelia is a serious complication of spinal cord trauma, occurring in approximately 28% of spinal cord injuries. Treatment options are limited and often produce unsatisfactory results. Post-traumatic syringomyelia (PTS) is presumably related to abnormalities of cerebrospinal fluid (CSF) and interstitial fluid hydrodynamics, but the exact mechanisms are unknown. Read More