ARACHNOIDITIS CASES

Palot et al () include arachnoiditis as a cause of prolonged neurological complications of obstetrical epidural analgesia, but concluded that long-term problems are rare.

Sghirlanzoni et al () discuss six patients with arachnoiditis secondary to epidural anaesthesia (no other risk factors were involved). Of these, only two patients had also had transient distress immediately following the procedure, and all the procedures had apparently been performed in a standard manner without obvious complication at the time.

Vandermeulen () includes arachnoiditis as a "mishap"& "solely due to & epidural anaesthesia". Haisa et al () state that lumbar adhesive arachnoiditis should be considered for differential diagnosis of back and leg pain after epidural anaesthesia. They discuss the case of a 30 year old patient who developed arachnoiditis after epidural intubation for anaesthesia during childbirth.

Furthermore, epidural anaesthesia may cause subarachnoid cysts or cavities, which are also recognised complications of arachnoiditis.

Torres et al() suggested that "meningeal inflammation may have left scars which later induced ischemia and subsequent cavitation." Alternatively, CSF flow may have been impeded, thus dilating the central canal and causing compressive ischaemia, thence myelomalacia and cavitation. They discussed seven patients with spinal arachnoiditis secondary to epidural anaesthesia, all of whom had subarachnoid cysts and five had cord cavitation.

Sklar et al() noted subarachnoid cysts on MR scan, with irregularity of the surface of the cord, intramedullary cysts and myelomalacia, in patients following epidural anaesthesia. However, in four cases, arachnoiditis was not suspected clinically.

Other authors() have also discussed arachnoid cysts secondary to epidural anesthesia.

Table of Contents

Introduction
TOXICITY OF LOCAL ANAESTHETICS
PREVIOUS SPINAL PROBLEMS
DURAL PUNCTURE
NEUROLOGICAL COMPLICATIONS OF EPIDURAL ANAESTHESIA
SHORT-TERM COMPLICATIONS
BACK PAIN FOLLOWING EPIDURAL ANAESTHESIA
LONG-TERM NEUROLOGICAL COMPLICATIONS
ARACHNOIDITIS CASES
NEXT: CONCLUSIONS
References