Post-traumatic arachnoiditis: an unusual cause of Brown-Sequard syndrome

Abstract

Brown-Sequard syndrome (BSS) is a unilateral cord injury characterised by an ipsilateral motor deficit with contralateral pain and temperature hypoaesthesia. Although there are a variety of causes, the majority of cases are generally of neoplastic origin or are traumatic in origin. We describe a rare cause of Brown-Sequard syndrome as a result of post-traumatic arachnoiditis. Magnetic resonance imaging with the use of thin-slice high-resolution constructive interference in steady state (CISS) and T2-weighted spin-echo sequence were used to demonstrate the cause and appearance of the lesion in the spinal canal and was useful in the assessment and management of the patient. This case illustrates the usefulness of the CISS sequence in MRI for elucidating arachnoiditis.

Fibromyalgia and arachnoiditis presented as an acute spinal disorder

“…Indeed, trauma or surgery has been observed to spark the progression of this disease. [118] Progression of the disease involves not only the peripheral nervous system but also the centrally located cores and paracores of the brain structures or better known as the greater limbic system as discussed above. Interestingly, abnormalities were noted at the thalamus on our patient's DTI and tractography [Figure 2] when compared with a healthy control.…”