Work

Atypical presentation of arachnoid web causing paraparesis with absence of sensory symptoms

Year: 2024

Type: article

Abstract: We present a man in his 60s with a dorsal thoracic arachnoid web spanning levels T6-T8. The patient presented with gait abnormalities, severe neuropathic lower back pain and mild urinary incontinence without sensory deficits. He underwent laminectomy with arachnoid web fenestration. At the 6-week postoperative follow-up appointment, he had increased muscle strength in his lower extremities and was able to walk without shuffling his feet, with a straight back and standing upright. This is a marked improvement from his previous hunched and shuffling gait. He has had partial resolution of his neuropathic low back pain. Arachnoid webs are often confused with other neurological disorders, most commonly idiopathic ventral cord herniation, which prolongs the time to surgical intervention. Eventual fenestration of our patient's web led to significant improvement in gait and partial relief of his neuropathic low back pain.

Source: BMJ Case Reports

DOI: 10.1136/bcr-2024-260850

Authors: Kyly M Hiatt, John Cauchi, Christopher Payne

Institutions: Burrell College of Osteopathic Medicine, University of New Mexico Hospital, University of New Mexico

Language: English

Topic: Spinal Dysraphism and Malformations

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

OpenAlex ID: W4403888377