West Virginia Medical Journal - 2026 - Quarter 2 | Page 20

CONCLUSION
Syringomyelia is a rare complication following subarachnoid hemorrhage. It is important to note that post-SAH syringomyelia may develop several years after the initial event. The obstruction secondary to arachnoiditis may be remote from the location of the syrinx, and the arachnoiditis or arachnoid scar may not be readily evident on imaging. The syringomyelia may be refractory to repeated surgeries, including lysis of adhesions or syrinx shunting. Ultimately, surgical strategies should be individualized and tailored to the specific underlying pathology. A combination of surgical interventions and interprofessional management may be required to maximize the benefit to the patient.
REFERENCES
1. Syringomyelia in Patients with Arachnoiditis at the Craniocervical Junction. World Neurosurg. 2017; 107:565- 573. doi: 10.1016 / j. wneu. 2017.08.064
2. Naito K, Yamagata T, Ohata K, Takami T. Safety and Efficacy of Syringoperitoneal Shunting with a Programmable Shunt Valve for Syringomyelia Associated with Extensive Spinal Adhesive Arachnoiditis: Technical Note. World Neurosurg. 2019; 132:14-20. doi: 10.1016 / j. wneu. 2019.08.103
3. Brodbelt AR, Stoodley MA, Klekamp J. Syringomyelia and the arachnoid web. Acta Neurochir( Wien). 2003; 145( 8): 707- 711. doi: 10.1007 / s00701-003-0071-9
4. Eneling J, Boström S, Rossitti S. Subarachnoid hemorrhage-associated arachnoiditis and syringomyelia. Clin Neuroradiol. 2012; 22( 2): 169-173. doi: 10.1007 / s00062-011-0082-5
5. Ishizaka S, Hayashi K, Otsuka M, et al. Syringomyelia and arachnoid cysts associated with spinal arachnoiditis following subarachnoid hemorrhage. Neurol Med Chir( Tokyo). 2012; 52( 9): 686- 690. doi: 10.2176 / nmc. 52.686
6. Klekamp J, Batzdorf U, Samii M, Werner Bothe H. Treatment of syringomyelia associated with arachnoid scarring caused by arachnoiditis or trauma. J Neurosurg. 1997; 86( 2): 233-240. doi: 10.3171 / jns. 1997.86.2.0233
7. Klekamp J. Treatment of syringomyelia related to nontraumatic arachnoid pathologies of the spinal canal. Neurosurgery. 2013; 72( 3): 376-389. doi: 10.1227 / NEU. 0b013e31827fcc8f
8. Kok AJM, Verhagen WIM, Bartels RHMA, Van Dijk R, Prick MJJ. Spinal arachnoiditis following subarachnoid haemorrhage: Report of two cases and review of the literature. Acta Neurochir( Wien). 2000; 142( 7): 795-799. doi: 10.1007 / s007010070094
9. Koyanagi I, Iwasaki Y, Hida K, Houkin K. Clinical features and pathomechanisms of syringomyelia associated with spinal arachnoiditis. Surg Neurol. 2005; 63( 4): 350- 355. doi: 10.1016 / j. surneu. 2004.05.038
10. Ohata K, Gotoh T, Matsusaka Y, et al. Surgical management of syringomyelia associated with spinal adhesive arachnoiditis. J Clin Neurosci. 2001; 8( 1): 40- 42. doi: 10.1054 / jocn. 2000.0731
11. Zuev AA, Lebedev VB, Pedyash N V., Epifanov DS, Levin RS. Treatment of syringomyelia associated with adhesive arachnoiditis. Zhurnal Vopr Nejrokhirurgii Im NN Burdenko. 2017; 81( 3): 39-47. doi: 10.17116 / neiro201781339-47
12. Chang HS, Nakagawa H. Theoretical analysis of the pathophysiology of syringomyelia associated with adhesive arachnoiditis. J Neurol Neurosurg Psychiatry. 2004; 75( 5): 754-757. doi: 10.1136 / jnnp. 2003.018671
13. Ki Hong Cho, Iwasaki Y, Imamura H, Hida K, Abe H. Experimental model of posttraumatic syringomyelia: The role of adhesive arachnoiditis in syrinx formation. J Neurosurg. 1994; 80( 1): 133-139. doi: 10.3171 / jns. 1994.80.1.0133
14. Heiss JD, Jarvis K, Smith RK, et al. Origin of Syrinx Fluid in Syringomyelia: A Physiological Study. Clin Neurosurg. 2019; 84( 2): 457-468. doi: 10.1093 / neuros / nyy072
15. Basaran R, Kaksi M, Efendioglu M, Onoz M, Balkuv E, Kaner T. Spinal arachnoid cyst associated with arachnoiditis following subarachnoid haemorrhage in adult patients: A case report and literature review. Br J Neurosurg. 2015; 29( 2): 285-289. doi: 10.3109 / 0268869 7.2014.976175
16. Morisako H, Takami T, Yamagata T, Chokyu I, Tsuyuguchi N, Ohata K. Focal adhesive arachnoiditis of the spinal cord: Imaging diagnosis and surgical resolution. J Craniovertebr Junction Spine. Published online 2010. doi: 10.4103 / 0974- 8237.77673
17. Inoue Y, Nemotor Y, Ohata K. Syringomyelia associated with adhesive spinal arachnoiditis: MRI. Neuroradiology. 2001; 43( 4): 325-330.
18. Atallah E, Dang S, Rahm S, et al. Rare case of diffuse spinal arachnoiditis following a complicated vertebral artery dissection. J Clin Neurosci. 2018; 52:132-134. doi: 10.1016 / j. jocn. 2018.03.005
19. Iwatsuki K, Yoshimine T, Ohnishi YI, Ninomiya K, Moriwaki T, Ohkawa T. Syringomyelia associated with spinal arachnoiditis treated by partial arachnoid dissection and syrinx-far distal subarachnoid shunt. Clin Med Insights Case Reports. 2014; 7:107-110. doi: 10.4137 / CCRep. S14895
20. Ewelt C, Stalder S, Steiger HJ, Brandt GH, Heilbronner R. Impact of cordectomy as a treatment option for posttraumatic and non-posttraumatic syringomyelia with tethered cord syndrome and myelopathy. J Neurosurg Spine. 2010; 13( 2): 193-199. doi: 10.3171 / 2010.3. SPINE0976
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