Arachnoid adhesions

Introduction The arachnoid membrane is composed of a thin connective tissue. It is a translucent membrane located deep in the hard brain (ridge). There is a potential cavity in the subdural space, and the cavity contains a small amount of cerebrospinal fluid. 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 action of certain etiologies. The main features of arachnoid thickening, adhesion and cyst formation. . According to clinical symptoms, there are common brain arachnoiditis, cerebral hemisphere convex arachnoiditis, and cerebrospinal arachnoiditis.

Cause

(1) Infection:

1. Central nervous system infection: It can be secondary to various types of meningitis, encephalomyelitis, especially serous meningitis caused by infections such as viruses.

2. Infections outside the central nervous system: Systemic infections such as colds, flu, rheumatism, pneumonia, tuberculosis, sepsis, pelvic infections, etc., may be the cause of the disease.

(2) Trauma:

Both craniocerebral trauma and spinal trauma can occur, the trauma can be very mild, and the cranial muscles or spine can be changed without fractures.

(3) foreign matter enters the subarachnoid space:

Such as: subarachnoid hemorrhage, antibiotics, anesthetics, contrast agents.

(4) The primary nervous system has primary lesions:

Such as: tumor, syringomyelia, optic neuritis, multiple sclerosis.

(5) Skull and spinal lesions: such as skull base depression, spinal bone hyperplasia, disc herniation, spinal stenosis, etc.

(6) Poisoning: such as lead poisoning and alcoholism.

(7) The cause is unknown: there may be non-suppurative meningitis with insignificant clinical signs or unidentified causes, especially caused by viral infection.

an examination

Related inspection

Microscopic examination of cerebrospinal fluid by brain CT examination

The clinical symptoms vary depending on the location of the disease. Common ones are:

(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 condyle.

(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.

(2) Spinal arachnoiditis: chest veins and cervical spinal cord lesions are more common. Early symptoms of post-root stimulation often cause root pain in the area affected by nerve roots. They vary in severity and can be relieved after rest, often lasting for several months. Different degrees of spinal cord compression symptoms appear several years later.

(C) cerebrospinal arachnoiditis: for the brain and spinal cord have lesions, both can occur at the same time, or from the spinal cord lesions to the posterior cranial concave skull base, resulting in the corresponding spinal cord and cranial nerve damage symptoms.

Check: Cerebrospinal fluid protein and cell count increased.

Differential diagnosis

Differential diagnosis of arachnoid adhesions:

1, arachnoid cyst: arachnoid cysts are divided into two types of 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.

2, arachnoid thickening: arachnoiditis refers to a tissue reaction of the brain or spinal arachnoid under the action of certain causes, with arachnoid thickening, adhesion and cyst formation as the main features. In essence, this is a pathological diagnosis, not a disease unit, more common in young and middle-aged.

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