Neeraj Kumar1. 1. Department of Neurology, Mayo Clinic, Rochester, MN.
Abstract
PURPOSE OF REVIEW: Superficial siderosis (SS) of the nervous system is often due to a dural pathology. This review focuses on recent developments related to the management of this subgroup of patients with SS. RECENT FINDINGS: The presence of an epidural ventral spinal fluid collection in patients with SS is a clue to the presence of a diskogenic dural defect. The location of the defect is ascertained by a dynamic CT myelogram, which involves placing the patient in a prone position with hips elevated. This permits gravity-assisted preferential ventral localization of the contrast and active scanning during contrast injection facilitates a precise delineation of the initial point of contrast extravasation which localizes the defect. SUMMARY: Diskogenic dural defects are commonly the underlying etiology for SS in patients with a ventral spinal fluid collection. A dynamic CT myelogram facilitates detection and subsequent repair of these defects, which arrests the continued low-grade subarachnoid bleeding.
PURPOSE OF REVIEW: Superficial siderosis (SS) of the nervous system is often due to a dural pathology. This review focuses on recent developments related to the management of this subgroup of patients with SS. RECENT FINDINGS: The presence of an epidural ventral spinal fluid collection in patients with SS is a clue to the presence of a diskogenic dural defect. The location of the defect is ascertained by a dynamic CT myelogram, which involves placing the patient in a prone position with hips elevated. This permits gravity-assisted preferential ventral localization of the contrast and active scanning during contrast injection facilitates a precise delineation of the initial point of contrast extravasation which localizes the defect. SUMMARY: Diskogenic dural defects are commonly the underlying etiology for SS in patients with a ventral spinal fluid collection. A dynamic CT myelogram facilitates detection and subsequent repair of these defects, which arrests the continued low-grade subarachnoid bleeding.
Authors: Carlo Brembilla; Luigi Andrea Lanterna; Virginio Bonito; Margherita Gardinetti; Gianluigi Dorelli; Angela Dele Rampini; Paolo Gritti; Claudio Bernucci Journal: J Neurosurg Spine Date: 2018-10-12
Authors: G Michael Halmagyi; Geoffrey D Parker; Luke Chen; Miriam S Welgampola; John D G Watson; Michael H Barnett; Michael J Todd; Shadi El-Wahsh; Victoria Rose; Marcus A Stoodley; Jeffrey W Brennan Journal: Eur Arch Otorhinolaryngol Date: 2022-07-16 Impact factor: 3.236