Neuroimaging findings and pathophysiology of dorsal spinal arachnoid webs: illustrative case
| Autor: | Tejas Karnati, Julius O. Ebinu, Nancy Pham, Lotfi Hacein-Bey |
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| Rok vydání: | 2021 |
| Předmět: |
Dorsum
CT = computed tomography Spinal arachnoid Neurodegenerative surgery Neuroimaging Clinical Research Medicine screening and diagnosis business.industry ultrasound CT myelogram Pain Research Neurosciences General Medicine Pathophysiology Detection arachnoid web MRI = magnetic resonance imaging Neurological Biomedical Imaging CSF = cerebrospinal fluid Chronic Pain business Neuroscience MRI 4.2 Evaluation of markers and technologies |
| Zdroj: | Journal of neurosurgery. Case lessons, vol 1, iss 20 |
| Popis: | BACKGROUND Spinal arachnoid webs are uncommon and difficult to diagnose, especially because causative intradural transverse bands of arachnoid tissue are radiographically occult. Left untreated, arachnoid webs may cause progressive, debilitating, and permanent neurological dysfunction. Conversely, more than 90% of patients may experience rapid neurological recovery after resection, even with a prolonged duration of presenting symptoms. Indirect imaging signs such as spinal cord indentation and compression with cerebrospinal fluid (CSF) flow alteration provide crucial diagnostic clues that are critical in guiding appropriate management of such patients. OBSERVATIONS The authors reported a patient with no significant medical history who presented with back pain, progressive lower extremity weakness, gait ataxia, and bowel and bladder incontinence. They discussed multimodality imaging for determining the presence of arachnoid webs, including magnetic resonance imaging, phase-contrast CSF flow study, computed tomography myelography, and intraoperative ultrasound. They also discussed the detailed anatomy of the spinal subarachnoid space and a plausible pathophysiological mechanism for dorsal arachnoid webs. LESSONS The authors report on a patient who underwent comprehensive imaging evaluation detailing the arachnoid web and whose subsequent anatomical localization and surgical treatment resulted in a full neurological recovery. |
| Databáze: | OpenAIRE |
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