Arachnoid thickening

Introduction Arachnoiditis refers to a tissue reaction of the arachnoid membrane of the brain or spinal cord under the influence of certain etiologies, characterized by arachnoid thickening, adhesion and cyst formation. In essence, this is a pathological diagnosis, not a disease unit, more common in young and middle-aged.

Cause

Department of arachnoid infection, trauma, foreign body, primary nervous system lesions, skull and spinal lesions, poisoning, etc., gradually thicken the arachnoid, causing damage to the spinal cord and nerve roots, or forming a cyst to block the medullary cavity, or affect the blood of the spinal cord The cycle eventually leads to dysfunction.

an examination

Related inspection

Brain ultrasound examination of brain CT

(a) brain arachnoiditis.

1. Posterior cranial fossa arachnoiditis:

(1) dorsal type: clinical symptoms are mainly caused by increased intracranial pressure, headache, vomiting, papilledema, etc., and can cause neck and neck pain and neck stiffness due to chronic occipital foramen.

(2) Ventral type: dizziness, nystagmus, deafness of the lesion side, tinnitus, peripheral facial paralysis, loss of facial sensation, loss of corneal reflex and limb ataxia.

2. Cerebral hemisphere convex arachnoiditis: The main symptoms are headache and seizures. Headaches can be limited or diffuse, generally mild, and sometimes aggravated when the head position changes. Epilepsy is mostly limited. Localized symptoms of neurological damage such as hemiplegia, aphasia, etc. are less severe.

3. Optic arachnoiditis: mainly headache and visual impairment.

(B) spinal arachnoiditis.

It is more common in the thoracic cord and cervical spinal cord disease. It is often the posterior root irritative symptom in the early stage. It causes root pain in the area affected by nerve roots. It varies in severity and can be alleviated after rest. It often lasts for several months and several degrees of spinal cord appear. Compression symptoms.

(C) cerebrospinal arachnoiditis.

There are lesions in the brain and spinal cord, both of which can occur simultaneously, or from the spinal cord lesions to the posterior cranial fossa skull base, resulting in corresponding spinal cord and cranial nerve damage symptoms.

an examination

The number of cerebrospinal fluid proteins and cells is increased.

Differential diagnosis

Subarachnoid hemorrhage: Most patients are conscious, such as dysfunction, or coma - awake - coma should consider continuing bleeding. Such as coma with respiratory frequency is not complete, high fever, is the symptoms of brain stem bleeding.

Arachnoid adhesion: is the main feature of arachnoiditis. Arachnoiditis refers to a tissue reaction of the arachnoid membrane of the brain or spinal cord under the influence of certain etiologies. The arachnoid thickening, adhesion and cyst formation are the main factors. feature.

Arachnoid cysts are divided into two types: congenital and secondary. The former is the problem of occurrence, and the latter is the result of extensive adhesion of the arachnoid membrane due to trauma, inflammation and the like. A congenital arachnoid cyst is a bag-like structure formed by the cerebrospinal fluid enclosed in the arachnoid membrane. Does not communicate with the subarachnoid space. Secondary patients develop cysts in the subarachnoid space due to arachnoid adhesions, which contain cerebrospinal fluid. Occurs in the small cranial fossa, also seen in the big pool of the pillow, the brain pool around the four-fold body and the upper pool.

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