- The middle of three membranes
covering the brain and spinal cord. Resembles a cobweb.
- 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.
- Bacterial, viral and fungal
- Blood in the CSF eg due
to trauma, subarachnoid haemorrhage.
- 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.
- Chronic intractable incapacitating
pain is the major symptom. Other manifestations are the result of sensory,
motor and autonomic nerve dysfunction.
- 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