Disease of cerebral arachnoiditis: symptoms and treatment

Infectious diseases of different etiology and localization after their generalization pose a danger not only from general intoxication, but also as a cause of inflammation of the membranes of the brain. As a rule, patients do not think much about it, and doctors can skip precursors of the development of complications.

Definition

Arachnoiditis is an inflammation of the spinal cord of the spinal cord or brain. This division is arbitrary, since isolated forms are not found in clinical practice. This is due to the device of the vascular system. The infection spreads from the hard or soft medulla, so arachnoiditis can be compared with serous meningitis.

The term "cerebral arachnoiditis" gradually turns into atavism, as it is pathomorphologically and clinically difficult to separate the inflammation of the arachnoid shell. Doctors are inclined to believe that all manifestations of skin irritation will be called meningitis.

History and etiology

For the first time the term "arachnoidite" in his dissertation was introduced into medicine Tarasenkov in the middle of the nineteenth century. A more detailed description of this disease was provided by a neurologist, Benninghaus. But he called it external serous meningitis.

Arachnoiditis, like inflammation of other membranes, occurs after acute and chronic infectious diseases, sinusitis, against the background of chronic intoxication with salts of heavy metals and traumas. In addition, the pathology may appear against the background of the oncological process and encephalitis.

Most often, the cause of arachnoiditis is chronic purulent otitis media and its complications: labyrinthitis, petrositis and sinustrombosis. Therefore, it is localized in the posterior or middle cranial fossa.

The disease with the flow is divided into acute, subacute or chronic. And according to the prevalence of the process, a sparse and limited arachnoidite is isolated. As a rule, they are combined or go one after the other in a clinical picture.

Symptoms

How does the disease manifest itself, such as cerebral arachnoiditis? Symptoms are a combination of cerebral and local disorders. The first are associated with an increase in CSF pressure, and the latter indicate the location of the inflammation focus. Depending on which symptom complex prevails, the manifestations of the disease may differ.

Most often in the clinic there are complaints of headache, which is accompanied by nausea and vomiting, not bringing relief. Pain can be focused in one place, amplified by movement, mental or physical stress. In addition, there is dizziness (even when lying down), irritability, severe weakness, combined with sleep disorders. There may be photophobia, intolerance of loud sounds, muscle rigidity.

But this is not the only thing that causes arachnoiditis of the brain. The signs of focal disturbances depend on the location of the pathological process. If the focus is on the convex surface of the brain, then, most likely, the patient will experience loss of functions, episodes of epileptic seizures. The location of the inflamed tissue on the lower surface of the brain causes disorders of the cranial nerves. These are symptoms such as decreased vision or loss of its fields, neuritis of the facial, trigeminal nerves, decreased sense of smell. They can be combined with manifestations of the defeat of the autonomic nervous system (excessive sweating, blue skin, thirst, frequent urination, increased blood glucose).

In the system of formation and circulation of the cerebrospinal fluid there can also be arachnoiditis of the brain. Symptoms of this condition are manifested in a sharp rise in temperature, vomiting, pain in the neck and occiput, nystagmus and an increase in tendon reflexes. In such cases, it is necessary to differentiate the pathological symptoms from the development of tumors of the posterior cranial fossa. But lumbar puncture can be carried out only if there are no stagnant phenomena on the fundus.

Cerebral arachnoiditis

If the inflammatory focus is located on a convex (convective) surface, then it is called "cerebral cerebral arachnoiditis." Symptoms include manifestations of brain damage and fluid outflow. Most often, the first sign is severe headaches. Because of the edema of the tissues, the normal circulation of the cerebrospinal fluid will be difficult, which will lead to its accumulation and development of intracranial hypertension.

Cerebral arachnoiditis of the brain, whose symptoms can mimic for other pathologies, is more often located in the frontal lobe, in the region of the central gyrus. Because of this, motor disorders often occur in the form of amplification or loss of movement or sensitivity. With irritation and compression of the cortex, there may be focal epileptiform seizures. In the case of severe course, there are large convulsive seizures that can change into epileptic status. In such cases, an important role is played by electroencephalography. Pneumography modern doctors use rarely because of the specific technique of introducing air under the membranes of the brain, although this method of investigation in this case is also very informative.

Optic-chiasmal arachnoiditis

In clinical practice, in the area of optic nerve intersection, the most common arachnoiditis of the brain. Symptoms of this localization are quite specific for timely diagnosis. Of the causes can be identified malaria, syphilis, craniocerebral injury and sore throat.

In the area of the intersection of the optic nerve, spikes and cysts with serous contents are formed, and in particularly neglected cases a dense scar tissue appears around the chiasma. This variant of the course of the disease is not strictly local. You can notice changes in the nervous tissue and at a significant distance from the hearth. Because of inflammation, the optic nerves on both sides are subjected to compression and, as a consequence, ischemia.

The disease develops slowly, first hitting one eye, and then, in a few weeks, and another. Throughout the development of the disease, the patient complains of pain behind the eyeballs. This allows for differential diagnosis with neuritis of various etiologies. To determine the site of inflammation use the definition of visual fields and examination of the fundus. The most specific is the loss of the temporal fields of vision or its concentric narrowing. This indicates that the focus of inflammation is in the center, between the visual tracts.

Arachnoiditis of posterior cranial fossa

In the posterior cranial fossa cerebral arachnoiditis of the brain is most often localized. Symptoms of it resemble tumors of the occipital lobe and consist of cerebellar and stem manifestations (defeat of the fifth, seventh and eighth pairs of cranial nerves).

The defeat of the cerebellum manifests itself in instability in walking and in a static position, a violation of the coordination of movements of the hands and feet, and also in the impossibility of simultaneously taking several actions, as the patient needs to visually control his limbs in order to do everything right.

Symptomatology depends on the type of inflammation (cyst or adhesive process), its localization and combination with hydrocephalus. The latter can arise because of overlapping of the holes of the lateral ventricles of the brain as a result of pathological changes in tissues. An excess of fluid irritates the meninges and causes an increase in intracranial pressure. Manifestations of this syndrome are severe headache, nausea, vomiting, dizziness, palpitation.

Spinal arachnoiditis

This type of lesion occurs when the infectious agent that causes arachnoiditis of the brain gets into the spinal cord with a flow of cerebrospinal fluid or circulation of blood. Symptoms and consequences depend on the spread of the process and the number of damaged roots. Causes of the disease in addition to the already named can be furuncles and purulent abscesses.

The clinic for lesions of the spinal cord is similar to that of an extramedullary tumor. The most frequent localization is the thoracic and lumbar segments, the region of the cauda equina. In the cerebrospinal fluid, cell-protein dissociation is observed. As a rule, the spinal form of arachnoiditis is chronic.

Diagnostics

When starting diagnostics, the doctor primarily collects an anamnesis of life and health, then conducts a physical examination, including describing the neurological status. And only after that it attracts additional laboratory and instrumental methods of research.

First of all, the neuropathologist's task is to exclude a brain tumor that can mimic brain arachnoiditis. Symptoms, skull photos on computer or magnetic resonance therapy will help in this. In addition, the craniogram will show signs of intracranial hypertension. Informative are the results of echoencephalography, angiography and scintigraphy, but the doctor primarily focuses on MRI.

Electroencephalography helps to locate inflammatory foci and to find out the cause of epileptic seizures. Analysis of cerebrospinal fluid shows a moderate number of cells, a slight protein dissociation, but cerebrospinal fluid flows under pressure, which confirms hydrocephalus. In addition, after this procedure, the patient's well-being is improved by reducing intracranial pressure.

Treatment

How to treat arachnoiditis of the brain? This task is quite laborious. First, you need to find out the cause of the inflammatory reaction and try to eliminate it. To do this, antibiotics of a wide spectrum of action are used that enter through the blood-brain barrier. To reduce edema of the tissues use antihistamines and desensitizing drugs.

Treatment of arachnoiditis of the brain is designed for long-term course therapy by means that dissolve scar tissue. In addition, it is necessary to normalize intracranial pressure, improve the outflow of cerebrospinal fluid, stimulate cerebral circulation and the delivery of oxygen to the nervous tissue.

In general, it is necessary to restore everything that has had time to damage arachnoiditis of the brain. Treatment with medicines, such as biogenic stimulants, "Lidase", "Pyrogenal", courses of fifteen injections every six months, gives positive results even in complex cases of the disease. To reduce pressure, use diuretics and decongestants. To arrest the convulsive syndrome, antiepileptic agents are excellent.

As a preventive treatment, general restorative therapy is performed, if there are additional problems, symptomatic treatment is performed.

Prognosis and prevention

Timely treatment of arachnoiditis of the brain, as a rule, ends in recovery. Danger can represent only the inflammatory process, which is located in the posterior cranial fossa and is accompanied by the overlapping of the ventricles of the brain. The frequent recurrence of the disease or its progressing course against the background of hypertensive crises, epileptiform seizures, as well as the localization of inflammation in the projection of the visual crossover, worsen the prognosis.

What should I do to prevent arachnoiditis of the brain? Consequences of it are serious enough, therefore it is necessary to pay attention to one's health and to turn in time to a medical institution for help. It is necessary to carry out prophylaxis of sinusitis, otitis and frontitis, to be vaccinated according to the calendar, and most importantly, to treat all infectious diseases in time and up to the end. Because they lead to the development of arachnoiditis.

Working capacity

Disease of cerebral arachnoiditis can cause disability of a person. Even against the background of relative clinical well-being, the consequences of the transmitted infection remain for life.

The third group of disability is assigned to patients who are able to serve themselves, and also perform light work. They are recommended to change their profession and lead the correct way of life, as far as possible.

Disability of the second group is obtained by the patient if, after treatment, he has episodes of epileptic seizures and reduced visual acuity. They can no longer perform their professional duties, but they are fully capable of serving themselves. Persons with disabilities in the first group are those who have completely lost sight as a result of the illness.

Patients with a third group are contraindicated in working at a height, at an open flame and moving mechanisms, in transport. It is recommended to exclude complicated meteorological conditions associated with changes in atmospheric pressure, work in noisy gassed rooms, work associated with vibration.

After the doctor diagnosed "cerebral arachnoiditis", the symptoms, treatment and rehabilitation of patients are carefully studied by experts of the medical and social expert commission. The decision to assign the status of a disabled person can be affected by any, even the most insignificant detail, since this is followed by certain benefits.