Spinal Adhesive Arachnoiditis with Severe Neurological Complications After Neuroaxial Anaesthesia
Anaesthesia-induced Spinal Adhesive Arachnoiditis
DOI:
https://doi.org/10.25751/rspa.19899Keywords:
adhesive arachnoiditis, anaesthesia, MRI, spinal cord, steroid administrationAbstract
Arachnoiditis is an inflammation of the arachnoid layer. When the condition is accompanied by accumulation of fibrinous adhesive bands leading to reduced blood supply, tethering and encapsulation/tethering of nerve roots and spinal cord, the term adhesive arachnoiditis (AA) is employed. AA resulting from procedures involving spinal anaesthesia and presenting with severe neurological debilitation is extremely rare but may present in many different forms. Such findings may develop anywhere from minutes to months after the procedures, and response scenarios can vary from spontaneous resolutions to intractable states. We herein present the cases of two patients with severe neurological sequalae after neuraxial anaesthesia and their respective management. Several distinct, probably concomitant and somewhat unpredictable factors may lead to or promote the development of AA after spinal anaesthesia. Nonetheless, even if not completely avoidable, awareness for the condition may allow for an earlier diagnosis and intervention, which may reflect in mitigated neurological sequels.
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