Adult-onset tethered cord syndrome with a retained medullary cord due to adhesive arachnoiditis

IF 0.4 Q4 CLINICAL NEUROLOGY Interdisciplinary Neurosurgery: Advanced Techniques and Case Management Pub Date : 2024-01-19 DOI:10.1016/j.inat.2024.101960

Akitaka Yoshimura , Hisaaki Uchikado , Youhei Iguchi , Shota Fujimura , Hideki Ohta

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Abstract

Background

Adult-onset tethered cord syndrome (ATCS) is occasionally reported, but older adult onset is very rare. We treated a patient who was asymptomatic until older adulthood and then developed subacute exacerbation of neurological symptoms.

Case description

A 76-year-old woman presented with bilateral leg pain, numbness, and weakness plus low back pain and dysuria for 1 month. Imaging showed a retained medullary cord with a syrinx and an enhanced mass lesion. She was diagnosed with symptomatic ATCS and underwent surgery. Intraoperative findings were an intramedullary syrinx and inflammatory granulation due to adhesive arachnoiditis.

Conclusion

We experienced a very rare case in which an older adult developed ATCS. Caution is required because idiopathic adhesive arachnoiditis can exacerbate the neurological symptoms.

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因粘连性蛛网膜炎导致髓质脊髓滞留的成人系带综合征

背景成人发病的系索综合征（ATCS）偶有报道，但老年人发病的情况非常罕见。病例描述：一名 76 岁的妇女因双侧腿痛、麻木、无力、腰痛和排尿困难就诊 1 个月。影像学检查显示，她的髓质脊髓有残留，并伴有鞘膜积液和增强的肿块病变。她被诊断为无症状 ATCS，并接受了手术治疗。术中发现髓内鞘膜积液和粘连性蛛网膜炎引起的炎性肉芽肿。特发性粘连性蛛网膜炎会加重神经症状，因此必须谨慎。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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