Ossification of spinal arachnoid with unrelated syringomyelia

Nagpal, RD; Gokhale, Sandeep; Parikh, V. R.

doi:10.3171/jns.1975.42.2.0222

Cited by 24 publications

(14 citation statements)

References 8 publications

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“…The calcified arachnoid plaques were resected to variable extents due to their firm adherence to the spinal cord. In several cases, the syrinx was aspirated and a syringoperitoneal or syringopleural shunt was inserted 5,6,8. Collapse of the syrinx was noted with some postoperative clinical improvement in two of these reports 5,8.…”

Section: Discussionmentioning

confidence: 95%

“…Syringomyelia in the setting of AO has been hypothesized to result from vessel ischemia, CSF flow alterations, or even as a coexisting incidental finding 2,5,6. In a large study of 105 patients, Milhorat and colleagues identified 23 cases of focal intramedullary cavitation separated from the fourth ventricle by a syrinx-free segment of spinal cord 11.…”

Section: Discussionmentioning

confidence: 99%

“…Over 50 reports of AO are documented in literature; however, only eight of these are associated with syringomyelia 2,3,4,5,6,7,8,9. The pathophysiology of syrinx development in this disease state is controversial.…”

Section: Introductionmentioning

confidence: 99%

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Arachnoiditis ossificans associated with syringomyelia: An unusual cause of myelopathy

Ibrahim

Kamali-Nejad²,

Fehlings³

2010

Evidence-Based Spine-Care Journal

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Objective: The pathophysiology of arachnoiditis ossificans (AO) and its association with syringomyelia remains a rare and poorly understood phenomenon. Here, we present a case of AO associated with syringomyelia, a review of literature, and a discussion of current understanding of disease pathophysiology.Methods: A literature review was performed using MEDLINE (January 1900–May 2010) and Embase (January 1900–May 2010) to identify all English-language studies that described AO with syringomyelia. The current report was added to published cases.Results: Over 50 cases of AO are reported in literature, of which only eight are associated with syringomyelia. The various presumptive etiologies of syrinx formation include abnormalities in blood circulation, ischemia, hydrodynamic alternations in cerebrospinal fluid (CSF) flow, tissue damage, or incidental coexistence. Changing CSF dynamics related to decreased compliance of the subarachnoid space and subsequent paracentral dissection of the spinal cord may be implicated in the disease process. magnetic resonance imaging (MRI) scanning may identify the syrinx but fail to diagnose the calcified arachnoid. Five patients, including the current case, improved clinically following laminectomy and decompression.Conclusions: Syringomyelia in association in AO is a rare phenomenon. A high index of suspicion is required and both MRI and computed tomography (CT) are recommended for diagnosis. The pathophysiology of syringomyelia in AO remains an area of ongoing research.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Arachnoiditis ossificans associated with syringomyelia: An unusual cause of myelopathy

Ibrahim

Kamali-Nejad²,

Fehlings³

2010

Evidence-Based Spine-Care Journal

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“…12,15,18,21,24,27,30 They suggest that ossification in AO results from an active, progressive process. These features indicative of true ossification have been noted systematically.…”

Section: Histological Featuresmentioning

confidence: 99%

“…12,15,18,21,24,27,30 They suggest that ossification in AO results from an active, progressive process. 18 The association of ossified arachnoid with contiguous and often extensive dense fibrosis of the arachnoid suggests that ossification is the end point of arachnoiditis. 27 This possibility was suggested by Slager, 24 who observed that incidental leptomenigeal plaques in an autopsy study were calcified and not ossified.…”

Section: Histological Featuresmentioning

confidence: 99%

Arachnoiditis ossificans of the cauda equina

Faure

Khalfallah²,

Perrouin-Verbe³

et al. 2002

Journal of Neurosurgery: Spine

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✓ The authors describe a case of arachnoiditis ossificans (AO) of the cauda equina. The lesion is a rare pathological entity usually confined to the thoracic and high lumbar regions that can cause progressive spinal cord and cauda equina compression, inducing severe neurological deterioration. The authors analyze the clinical symptoms, radiological features, histological data, and treatment options relating to this case and 13 others described in the literature; additionally, they consider the possible mechanisms responsible for ossification of the leptomeninges. Although clustered arachnoidal cells are usually implicated in its pathogenesis, an environment induced by arachnoiditis and disturbed cerebrospinal fluid flow appears to be a more important factor. A therapeutic strategy is proposed for AO for which no effective treatment currently exists.

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