颈胸段蛛网膜炎——颅内动脉瘤性蛛网膜下腔出血的一种罕见并发症。
Cervicothoracic arachnoiditis-a rare complication of aneurysmal intracranial subarachnoid haemorrhage.
作者信息
Swarna Shyam S, McKean David, Belci Maurizio
机构信息
1Rehabilitation Medicine, Oxford University Hospitals NHS Trust, Oxford, UK.
2Radiology Department, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, UK.
出版信息
Spinal Cord Ser Cases. 2018 Jun 28;4:57. doi: 10.1038/s41394-018-0089-0. eCollection 2018.
INTRODUCTION
Subarachnoid haemorrhage is a catastrophic condition which has significant morbidity and mortality, with mortality rate ranging between 8-67% and is associated with significant morbidity among the survivors. Arachnoiditis of the spinal cord is a very rare complication which can occur months to years after the subarachnoid haemorrhage.
CASE PRESENTATION
We report a case of cervicothoracic arachnoiditis following the subarachnoid haemorrhage secondary to posterior inferior cerebellar artery (PICA) aneurysm with posterior fossa AVM (arterio-venous malformation) causing dense paraplegia.
DISCUSSION
The haemorrhage that occurs into the fourth ventricle passes to the subarachnoid space via foramen of Magendie and Luschka. This subsequently induces inflammatory changes of the meninges predisposing to arachnoiditis. Early recognition and intervention may prevent this devastating complication or at least reduce the morbidity.
引言
蛛网膜下腔出血是一种灾难性疾病，具有很高的发病率和死亡率，死亡率在8%至67%之间，且幸存者中存在严重的发病情况。脊髓蛛网膜炎是一种非常罕见的并发症，可在蛛网膜下腔出血数月至数年之后发生。
病例报告
我们报告一例继发于小脑后下动脉（PICA）动脉瘤伴后颅窝动静脉畸形（AVM）的蛛网膜下腔出血后发生颈胸段蛛网膜炎的病例，该病例导致严重截瘫。
讨论
流入第四脑室的出血经马让迪孔和路施卡孔进入蛛网膜下腔。这随后引发脑膜的炎症变化，易导致蛛网膜炎。早期识别和干预可能预防这种毁灭性并发症，或至少降低发病率。
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