Arachnoiditis Definitions

Arachnoid.

The middle of three membranes covering the brain and spinal cord. Resembles a cobweb.

 

 

Arachnoiditis.

Inflammation of the arachnoid membrane and underlying space (which contains cerebrospinal fluid).

 

 

Adhesive Arachnoiditis.

A chronic form of arachnoiditis in which the arachnoid membrane undergoes thickening and there is diffuse connective tissue proliferation in the subarachnoid space.

Causes:

Infections.

Bacterial, viral and fungal meningitis.

 

Blood

Blood in the CSF eg due to trauma, subarachnoid haemorrhage.

 

Iatrogenic.

Introduction of substances into the subarachnoid space, eg dyes for myelograms, or by inadvertent penetration into the subarachnoid space of steroids or spinal anaesthetics while giving epidural injections.

 

Pathological Effects.

The scarring leads to clumping, distortion and strangulation of the nerve roots and blood vessels, with varying degrees of obliteration of the subarachnoid space. Nerve roots sustain direct injury and the spinal cord undergoes secondary degeneration.

 

 

Symptoms.

Chronic intractable incapacitating pain is the major symptom. Other manifestations are the result of sensory, motor and autonomic nerve dysfunction.

 

 

Prognosis.

As there is no known cure. Treatment is directed at promoting the best quality of life possible in the circumstances. This involves treatment of symptoms, with pain management being the main consideration, and appropriate disability aids.