Superficial Siderosis associated with Dural Ectasia and Meningeal Cysts::A Case Report

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Superficial siderosis (SS) of the central nervous system (CNS) is characterized by the deposition of hemosiderin on the surface of the CNS due to chronic and recurrent subarachnoid hemorrhage. This results in irreversible neurological deficits. We present a case of SS associated with an idiopathic meningeal cyst, dural ectasia, and scalloping of the vertebral bodies. A 51-year-old male presented with drowsiness and bloody cerebrospinal fluid. His medical records revealed perceptive hearing impairment that had developed in his early teens; generalized motor weakness, hypesthesia, and ataxia which had progressed over 10 years; and frequent episodes of transient disturbance of consciousness (drowsiness) since the age of 46. MRI revealed atrophy of the cerebellum, the brain stem, and the spinal cord with low signal intensity on their surfaces. This low signal intensity, indicating the deposition of hemosiderin, was more detectable by gradient echo T2<SUP>*</SUP>-weighted MRI than by other MRI conditions. A meningeal cyst at the level of Th1-2 and dural ectasia with scalloping of the C2-Th3 vertebral bodies were also revealed. It was considered that either of these two conditions could have led to the bleeding, because no other lesions were exposed. We did not continue with follow-up treatment, because he was bedridden and it was considered that no treatment would be effective in reversing his condition.
日本脊髄外科学会の論文