Considerations for delayed-onset spinal arachnoid web after intracranial subarachnoid hemorrhage

Georgia Wong; Gnel Pivazyan; Jeffrey M Breton; Ehsan Dowlati; Daniel R Felbaum

doi:10.4103/bc.bc_99_23

Considerations for delayed-onset spinal arachnoid web after intracranial subarachnoid hemorrhage

Brain Circ. 2024 Jun 26;10(2):89-93. doi: 10.4103/bc.bc_99_23. eCollection 2024 Apr-Jun.

Authors

Georgia Wong¹, Gnel Pivazyan^{2

3}, Jeffrey M Breton^{2

3}, Ehsan Dowlati^{2

3}, Daniel R Felbaum^{2

3}

Affiliations

¹ Department of Neurosurgery, Georgetown University School of Medicine, Columbia, Washington, USA.
² Department of Neurosurgery, MedStar Georgetown University Hospital, Columbia, Washington, USA.
³ Department of Neurosurgery, MedStar Washington Hospital Center, Columbia, Washington, USA.

Abstract

Spinal arachnoid web (AW) is a rare condition causing spinal cord-related issues. Its cause is often idiopathic but can be linked to past trauma or spine surgery. We describe two cases of AWs that developed after subarachnoid hemorrhage (SAH). Case #1 is a 71-year-old male with nonaneurysmal SAH who developed myelopathy 1 year later. Magnetic resonance imaging revealed upper thoracic cord edema and an AW. Case #2 is a 57-year-old female who underwent coiling of a ruptured basilar artery aneurysm and ventriculoperitoneal shunting for hydrocephalus. Twenty months later, she developed mid-thoracic AW requiring surgical resection. Both patients showed symptom improvement postresection avoiding further reoperation. History of SAH is emerging as a risk factor for AW development, emphasizing the importance of monitoring delayed-onset myelopathy and back pain in recent SAH patients.

Keywords: Arachnoid web; arachnoiditis; intradural; spinal cord; subarachnoid hemorrhage.