Postlumbar puncture arachnoiditis
mimicking epidural abscess.
The treatment with intrathecal amphotericin B presents a high risk of arachnoiditis
, which would not be an ideal option for this patient who has been already diagnosed with myelitis of the cervical spine and arachnoiditis
of the lumbar spine.
Our case 1 showed spine involvement with arachnoiditis
Slides were prepared, stained with hematoxylin and eosin, and evaluated by the same pathologist, who was blinded to the experimental group, for the presence or absence of lesions in accordance with the following guidelines: type of lesion (1 = arachnoiditis
; 2 = arachnoiditis
and nerve injury; 3 = nerve damage); extent of damage (1 = < 10%; 2 = 10%-50%; 3 = > 50%); lesion depth (1 = white matter; 2 = gray matter; 3 = white and gray matter); and blood vessel morphology (1 = normal, 2 = with fibrous thickening, 3 = with thrombosis).
During the operation, the patient underwent a laminectomy of L3-L5; intraoperative findings showed an intradural abscess and arachnoiditis
, with edema and adherence of the cauda equina nerve roots (Figure).
The possible complications are pain during injection, paresthesia, and chemical arachnoiditis
. Furthermore, the spread of hypertonic saline in the diseased epidural space or to the subdural space is difficult to predict, due to scarring, narrowing, and adhesion.
In several cases, the direct complications of dural tear include postural headache, meningeal pseudocyst, arachnoiditis
, or meningeal infection.
Repeated punctures are not without risk and can result in low pressure headaches, CSF leak, infection, and arachnoiditis
. Fluoroscopic guidance may be beneficial in obese patients when body landmarks are difficult to distinguish.
SK has been reported in idiopathic spinal cord herniation [sup] and spinal column shortening surgery.[sup] Miyazaki et al .[sup] reported that focal adhesive arachnoiditis
might be the cause of SK in a patient with thoracic OLF.
(13,14) Common manifestations of coccidioidal meningitis include hydrocephalus, cerebral infarction, vasculitis, parenchymal or parameningeal masses and abscesses, periventricular white matter abnormalities, and spinal arachnoiditis
. (15,19-21) Subarachnoid hemorrhage from vasculitis or ruptured mycotic aneurysm and intrasellar granuloma formation are among the rarer complications that have been reported in the literature.
The patient suffered neurologic sequelae from his disseminated TB including TB meningitis, TB arachnoiditis
and TB granulomata.
Ron has an agonising and incurable spinal problem called arachnoiditis
which he claims comes from being given epidural jabs of the steroid Depo-Medrone.
One patient had arachnoiditis
. Five patients had disease involving more than 2 vertebrae.
Serious central neuraxial infections such as arachnoiditis
, meningitis, and abscess following spinal or epidural anesthesia are rare.