Arachnoiditis of the posterior cranial fossa symptoms. Principles of diagnosis and therapy. What's going on in your head

Arachnoiditis of the brain, the symptoms of which may include varying degrees severity is inflammation of one of the membranes (the so-called arachnoid) of the brain. This disease can cause permanent disability. This danger makes actual problem timely diagnosis and complete treatment of the disease.

To the characteristic features cerebral arachnoiditis include a decrease in the rate of blood outflow and an increase in the permeability of capillary walls. The combination of these factors leads to the development of congestion in the soft tissues. These features largely determine the clinical picture of the disease.

1. Infectious-inflammatory, and according to some data, infectious-allergic diseases. For this reason, the majority (about 60%) of cases of cerebral arachnoiditis occur (pneumonia, sinusitis, tonsillitis, tonsillitis, and meningitis also play a role).
2. Previous traumatic brain injuries. This group includes 30% of cases of inflammation of the arachnoid meninges(post-traumatic arachnoiditis). Closed craniocerebral injuries are also important.
3. Long-term chronic infectious and inflammatory diseases of the ENT organs.
4. Intracranial abscesses and neoplasms.
5. Endocrine disorders.
6. Risk factors also include chronic intoxication of the body (alcohol, lead, etc.).
7. There is evidence that in some cases the cause may be birth trauma.
8. In some episodes of diagnosed arachnoiditis immediate cause its development cannot be established.

Favorable conditions for the development of arachnoiditis arise when the protective function decreases immune system in a weakened body.

Classifications

Currently for more accurate description pathological process, clinicians use two main classifications.

Depending on location:

1. Arachnoiditis of the posterior cranial fossa.
2. Basal arachnoiditis is localized at the base of the brain.
3. Convexital arachnoiditis is located in the area of ​​the convex part of the surface cerebral hemispheres brain.
4. Optico-chiasmatic arachnoiditis - inflammation of the arachnoid membrane in the area of ​​chiasm optic nerves.
5. Arachnoiditis of the cerebellopontine angle.

Taking into account morphological features:

1. Sticky.
2. Cystic-adhesive.
3. Cystic.

Clinical picture

Symptoms characteristic of cerebral arachnoiditis fall into two main groups:

1. The so-called cerebral symptoms that allow one to suspect pathological process.
2. Specific signs indicating the localization of the inflammatory focus ( focal symptoms).

General and cerebral symptoms:

1. Headache. Characteristic feature The severity of the symptom is greatest in the morning. In some cases, headaches may be accompanied by nausea and vomiting. Increased intensity of spasms occurs with awkward, careless movements, straining, and tension. The pain can be either diffuse or local.
2. Dizziness.
3. Memory loss.
4. Affective disorders, as a rule, are manifested by increased irritability; the same symptom can also be attributed to manifestations of asthenic syndrome.
5. Asthenic syndrome is manifested by general weakness and unusually rapid fatigue.
6. Dissomnias.
7. Severe weather sensitivity may occur.

Symptoms indicating the localization of the pathological focus:

1. With arachnoiditis of the posterior cranial fossa, the leading focal symptoms are ataxia (disorder of the ability to coordinate movements) and nystagmus. Examination of the fundus in this situation will reveal optic neuritis. Often, with this form of arachnoiditis, hearing impairment occurs.
2. Basal arachnoiditis is characterized by loss of function of the cranial nerves located at the base of the brain.
3. The inflammatory process with convexital localization manifests itself as a convulsive syndrome in the form of so-called Jacksonian or general epileptic paroxysms.
4. Optico-chiasmal localization causes visual disturbances. Such patients complain of a “mesh in front of the eyes”; in severe cases, complete loss of vision and blindness occur. In addition, cerebral arachnoiditis of opticochiasmal localization can also manifest itself with hypothalamic disorders, such as thirst, increased urination
5. The localization of the pathological process in the area of ​​the cerebellopontine angle is indicated by paroxysmal pain in the back of the head, obsessive dizziness and rumbling noise in the ears. The patient experiences serious difficulty maintaining balance.
6. Arachnoiditis of the occipital cistern is characterized by signs of damage facial nerve. This form is characterized by a very acute onset, accompanied by a pronounced increase in body temperature.

Variants of the course of cerebral arachnoiditis

1. An acute course is characteristic of arachnoiditis of the cisterna magna. The clinical picture is dominated by severe headaches, vomiting and fever. With timely selection of correct therapy, cure is possible without consequences or residual effects.
2. Subacute course occurs most often. General symptoms (dizziness, sleep disorders, general weakness) are not pronounced. There are focal symptoms (disorders of hearing, vision, coordination), expressed to varying degrees.
3. Chronic course occurs when acute symptoms are ignored or under acute inflammation. Chronic clinical variant arachnoiditis in the absence of therapy develops quickly and is characterized by gradual progression of symptoms.

Diagnostics

The diagnosis of cerebral arachnoiditis is made based on the characteristics clinical picture disease and the results of an objective examination of the patient. The following measures help with diagnosis:

• neurological examination of the patient;
• examination by an ophthalmologist, including examination of visual acuity, visual fields and fundus examination;
• A clinical blood test helps identify the presence of inflammatory process in organism;
• X-ray of the skull without contrast ( this method reveals indirect signs of intracranial hypertension);
• electroencephalography;
• pneumoencephalography is a study that can reveal uneven filling of the subarachnoid space with air, as well as dilated cerebral ventricles, focal accumulations of air;
• computed or magnetic resonance imaging with high degree reliability establishes the degree pathological changes arachnoid membrane, localization of cysts, and also help with differential diagnosis;
• scintigraphy.

Treatment

Conservative treatment

Cerebral arachnoiditis takes a long time to treat. The therapeutic regimen involves repeated treatment courses with a frequency of once every four to five months.

The best results are achieved by therapy started in the stage of acute inflammation. This clinical variant of the disease can be cured before the formation of irreversible pathological changes. This means that there is a high probability complete cure without long-term consequences.

Therapy for this disease is carried out in the following main areas:

• antibacterial therapy aimed at eliminating the primary infectious focus;
• anti-inflammatory therapy;
• absorbents;
• hyposensitizing effects;
• dehydration therapy is relevant in connection with intracranial hypertension and is used to avoid complications that may be caused by increased intracranial pressure;
• anticonvulsant therapy is carried out when convulsive syndrome;
• symptomatic therapy is carried out as needed.

Possibility of surgical treatment

Surgical treatment of cerebral arachnoiditis has the following indications:

• insufficient effectiveness or ineffectiveness of conservative therapy;
• progression of intracranial hypertension despite drug treatment;
• increasing severity of focal symptoms;
• optico-chiasmatic form of arachnoiditis with progressive deterioration of vision.

This situation often occurs, for example, with cystic adhesive arachnoiditis, when there is severe circulation difficulty cerebrospinal fluid.

Consequences and prognosis

The consequences of arachnoiditis, even if not life-threatening, nevertheless significantly limit life activity, freedom of choice of profession, and sometimes movement, and can also lead to long-term partial or complete loss of ability to work. In order to avoid the development of consequences or to minimize them, it is unacceptable to ignore the first signs of the disease. They are a signal to seek medical advice and detailed medical examination. Timely diagnosis and correctly selected treatment is a chance to prevent the development of complications.

Hydrocephalus

A long-term inflammatory process in the area of ​​the arachnoid membrane of the brain leads to a persistent increase in intracranial pressure, which, in turn, leads to the formation of hydrocephalus. Two main mechanisms for the development of this condition are considered:

• decreased relative to normal outflow of cerebrospinal fluid from the ventricles of the brain;
• difficult reabsorption of cerebrospinal fluid.

The course of hydrocephalus is characterized by periodically occurring liquorodynamic crises, for which, in addition to increased headaches, dizziness and orientation disorders are typical.

Thrombosis or embolism of cerebral vessels

Severe obstruction of patency cerebral vessels can lead to a very serious complication - acute disorder cerebral circulation according to the ischemic type.

Epileptic syndrome

This complication is characteristic mainly of the convexital form of cerebral arachnoiditis. Convulsive syndrome significantly reduces the quality of life and limits ability to work, and is often the cause of its permanent loss.

Patients suffering from epileptic syndrome require continuous therapy with anticonvulsants. The anticonvulsant drug and dosage regimen are selected by a neurologist and an epileptologist. In the future, such a patient should be observed for a long time by a neurologist. Treatment with anticonvulsants is carried out under regular electroencephalography monitoring.

Visual disorders

Both visual acuity and visual fields suffer (they narrow). Such patients cannot work with small objects or parts; any activities associated with visual strain are contraindicated for them.

Prevention

The following measures will help to avoid cerebral arachnoiditis:

• timely detection and treatment of diseases that can lead to arachnoiditis: sanitation of infectious and inflammatory foci, elimination of intoxications, adequate complex therapy in the case of cranial brain injuries;
• a set of measures to strengthen the body's defenses.

The brain and spinal cord of each person are covered with three membranes: hard, arachnoid (arachnoid) and soft. Quite often, damage to one membrane leads to the transfer of bacteria to other membranes.

Like any pathology, it affects general activities systems, as well as on human well-being. Headaches are one of the signs of arachnoiditis.

What it is?

What it is? Arachnoiditis is an inflammation of the arachnoid membrane of the brain, less commonly spinal cord. Under the arachnoid membrane there is a liquor space. With arachnoiditis, adhesions and cysts form (sticking together of three membranes due to thickening and compaction, loss of elasticity of the affected one), which block the natural circulation of fluid, causing it to stagnate, accumulate and provoke intracranial pressure. In medicine, this phenomenon is called an “arachnoid cyst.”

Since the arachnoid membrane is integral from the others, the infection is often transmitted between the three membranes of the brain. This is called leptomeningitis.

According to flow forms, they are divided into:

1. Spicy;
2. Subacute;
3. Chronic (cystic).

By type they are divided into:

• Cerebral - inflammation of the membrane on the convex surface, postcranial fossa or at the base of the brain. This syndrome accompanied by headaches, which intensify with overheating, physical or mental activity, hypothermia;
• Convexital – characterized by convulsive seizures and loss of consciousness. Divided by:

1. Frontal;
2. Parietal;
3. Temporal;
4. Central meandering.

• Basal is divided into:

1. Optico-chiasmatic (infectious) - occurs as a result of infection of the chiasmatic region of the brain or after traumatic bruises. Cysts and adhesions form, and neuritis or congestion is possible in the fundus. This leads to loss of vision.
2. Posterior cranial fossa - localization of inflammation in the cerebellopontine angle. Head pain, vomiting, nausea, dizziness occur. Looks like a tumor.
3. Cerebellopontine angle (transverse cistern) – unilateral hearing loss, the facial nerve is affected, cerebellar disorders appear;
4. Interpeduncular – sensory and motor information is disrupted.
   • Spinal – damage to the membrane in the spinal cord after injury. Symptoms appear months and years later: pain, weakness in the arms and legs. It is rare in children. Located in:

1. neck;
2. chest;
3. lumbar;
4. sacral levels.

• Adhesive (purulent) – purulent inflammation, which forms adhesions and causes headaches;
• Cystic (chronic) – inflammation with the appearance of cavities, which is characterized by pain in the head;
• Cystic-adhesive - clumping and formation of cysts, in some places the membrane adheres to the brain, which leads to seizures.

According to the location of the disease, they are distinguished:

1. Limited arachnoiditis;
2. Common arachnoiditis.

Causes

The causes of arachnoiditis of the brain mucosa are:

1. Infections;
2. Intoxication;
3. Traumatic bruises and concussions;
4. Inflammatory processes of the throat, nose or ear;
5. Severe intoxication with substances: alcohol, poisons, arsenic, lead, etc.;
6. Spinal injuries.

Symptoms and signs

Highlight general symptoms arachnoiditis of the brain mucosa. What are these signs?

• It appears one and a half weeks after infection;
• Headaches that occur in the morning or at night;
• Deterioration of vision;
• Heaviness in the head;
• Sleep disturbance;
• Deterioration in performance;
• Nervous exhaustion: apathy, fear, depression, fatigue, anxiety, aggression;
• Vegetative-vascular disorders: sensitivity to changes in weather, altitude, hunger, temperature; dizziness, dizziness blood pressure, fainting, feelings of cold or heat;
• Change in sensitivity: pain, tactile, temperature discomfort, numbness;
• Metabolic disorders;
• Short-term loss of consciousness;
• Cramps in various parts bodies and seizures;
• Strabismus, impaired coordination of the eyeballs.

In the cerebral form, the main symptom is headache of a general, less often local, nature.

With the convexital form, sensitive and movement disorders. Convulsive seizures are observed.

In the optico-chiasmatic form, the process begins with a decrease in vision and intracranial pressure.

When the posterior cranial fossa is affected, tinnitus, staggering and dizziness occur, followed by some hearing loss.

With the spinal form, pain occurs in the back and limbs.

In cystic adhesive disease, seizures are observed.

The child has

Arachnoiditis in a child manifests itself in headaches, drowsiness, lethargy, visual disturbances and convulsions. Often observed after bruises and traumatic situations. Less common cause various pathologies brain or spinal cord.

In adults

Inflammation of the arachnoid membrane of the brain often occurs in people under 40 years of age. The main causes are influenza, rhinosinusitis, otitis in 60%, traumatic brain injury in 30%, chronic tonsillitis.

In men and women, arachnoiditis often occurs due to physical and mental fatigue. If the skull is not damaged by traumatic bruises, then this does not cause headaches. Sometimes lack of sleep and overwork in adulthood become the causes of the first signs of intracranial pressure, but without the formation of adhesions or cysts.

Diagnostics

Diagnosis of arachnoiditis begins with questioning and conversation in combination with general inspection sick. It is necessary to understand the reasons that led to the disease, and they often lie in a person’s lifestyle. Thus, anamnesis is collected (lifestyle, habits, working and living conditions, etc.) and complaints (what specific symptoms are troubling, when and how often they occur, for what reasons, etc.). After a general examination, the doctor performs an instrumental examination to clarify the diagnosis:

• MRI of the brain, which shows cysts, adhesions and swelling in the parotid areas;
• Blood and cerebrospinal fluid analysis to identify the infectious nature of the disease;
• Neurological examination for sensitivity, coordination, reflexion, etc.;
• Electroencephalography to examine the brain;
• Examination of cerebral vessels.

Treatment

The most important stage of treatment for arachnoiditis is not limited to medical manipulations and taking pills, which should include A complex approach when the patient himself helps improve his own condition.

Medicines for the treatment of inflammation of the brain mucosa:

1. Antibiotics when identifying the infectious nature of the disease. The main thing is to eliminate the source of the disease, so that you can then get rid of the symptoms;
2. Vitamins to strengthen the immune system, which must cope with such diseases;
3. Karipain and Longidaz to reduce intracranial pressure;
4. Nootropics to improve oxygen supply to cells;
5. Antidepressants to improve mood, increase activity and performance, return sober and positive thinking;
6. Antioxidants for the purpose of cell resistance to intracranial pressure;
7. Anticonvulsants;
8. Antihistamines and desensitizing agents: histaglobulin, diphenhydramine, suprastin, diazolin, calcium chloride, tavegil, pipolfen;
9. Diuretics to relieve intracranial pressure;
10. Glucocorticoids.

How else is arachnoiditis treated?

• Psychotherapy, massage and therapeutic exercises to eliminate nervous exhaustion;
• Therapy general condition, in which blood pressure, metabolism, and blood circulation are normalized, adhesions and cysts are resolved.

Folk remedies for the treatment of inflammation of the brain mucosa:

• It is good to use decoctions and infusions of coltsfoot, arnica and elecampane;
• Can be used essential oils to improve immunity and restore general health;
• News moon calendar and note the influence of the moon on personal well-being.

You should adhere to a diet that should be light and fortified. You should not eat fried, fatty, starchy foods that weigh down your stomach. The diet should be full of fruits and vegetables, which are rich in fiber and vitamins.

Lifespan

Arachnoiditis does not shorten life expectancy. Leaking in mild form, which most often happens, it only periodically bothers a person with its symptoms. How long do patients live? Full life. Danger arises only in the form of damage to the posterior cranial cavity.

A person’s ability to work depends on how completely he or she is cured. This disease characterized by its frequency, due to which performance may be reduced. However, causes of occurrence, for example, of a traumatic nature, may not cause repeated attacks.

Complications are considered:

• Stagnation of cerebrospinal fluid;
• Decreased vision;
• Frequency of seizures.

Lack of proper treatment and healthy image may lead to disability:

1. The first group is observed in the optico-chiasmatic form, when vision is impaired, which slightly reduces performance;
2. The second group – decreased performance due to periodic seizures, disturbances in well-being, vision and hearing;
3. The third group is characterized by the need to work less and change professions, which will allow them to relax more.

In order not to provoke complications and the disease itself, it is necessary to carry out preventive measures treatment: rest, fill the body with vitamins, take walks fresh air, receive timely treatment for infectious diseases, undergo a rehabilitation course after bruises and concussions.

When the arachnoid membrane of the brain becomes inflamed, cysts and adhesions form in it. This disease is called arachnoiditis and occurs as autoimmune reaction for neuroinfection. It can be triggered by traumatic brain injury, intoxication, exhaustion of the body, or climate change. Manifests itself as intracranial hypertension syndrome, asthenia or neurasthenia. Focal signs depend on the location of the lesion.

Read in this article

Causes of development of cerebral arachnoiditis

In half of the patients, the disease was preceded by influenza, meningitis or viral encephalitis, measles, and chickenpox. The second most common cause of development is a focus of inflammation in the area of ​​the ENT organs: tonsillitis, inflammation of the middle ear, mastoid process. A third of patients suffered from traumatic brain injury and cerebral hemorrhage.

In approximately 10%, the cause of arachnoiditis is unknown.

At the same time, the severity primary lesion does not affect the occurrence of pathology, predisposing factors may be:

• severe fatigue due to physical, emotional or mental stress;
• unfavorable climatic conditions or their sudden change;
• frequent viral and bacterial infections;
• alcoholism;
• concussions;
• injuries.

What's going on in your head

The membranes of the brain have a layered arrangement: hard, arachnoid and soft. The arachnoid does not merge with the others, it fits tightly to the soft one, but does not go into the convolutions. Therefore, communicating spaces are formed between them, which are filled with liquid. Through them there is an outflow of cerebrospinal fluid from the cranial cavity.

If to own cells Antibodies are formed in the arachnoid membrane, they are fixed on it in the form of complexes, causing an inflammatory reaction. At the same time, the shell thickens and grows with fibers connective tissue with the formation of adhesions and cysts. The movement of cerebrospinal fluid is inhibited. This leads to hydrocephalus and attacks of increased intracranial pressure.

General cerebral signs are accompanied by focal ones, which depend on the area of ​​damage to the brain structures.

Types of arachnoiditis

According to the level of the inflammatory process, all arachnoiditis is divided into cerebral (convexital, basilar, posterior cranial fossa) and spinal.

These diseases may have common and different (focal) signs that are associated with the specific affected area and the nature of the pathological processes.

Cerebral

Manifestations of the disease occur after sufficient for a long time after the factor that gave impetus to arachnoiditis. A viral infection can manifest itself as a complication after 4 to 11 months, and a skull injury makes itself felt even after 2 years of an asymptomatic period. Therefore, it is not always possible to connect these processes. The typical onset is weakness, insomnia, and mood instability. In this case, convulsions and attacks of the type of epilepsy are possible.

General cerebral symptoms are formed as a reaction to difficulty in the outflow of fluid:

• morning bursting headache, worse with tension, coughing;
• pressing pain in the eyes;
• nausea, sudden paroxysmal vomiting;
• decreased hearing;
• dizziness;
• increased sensitivity to loud sounds, bright light.

Vegetative crises are accompanied sudden increase or decreased blood pressure, pulse, difficulty breathing, sweating. They alternate with attacks of cerebrospinal fluid dynamics disturbances - unbearable headache, nausea and vomiting. A severe crisis can last more than a day.

Convexital (cranial vault)

weakens motor function and tenderness in the arm and leg on the opposite side of the lesion. There are epileptic seizures in various forms.

Basilar (base of the brain)

Memory, attention decreases, suffers mental activity, vision decreases, visual fields narrow.

Posterior cranial fossa

Weakened hearing, damage to the trigeminal and facial nerves, impaired coordination of movements, gait, dizziness. As it progresses, paresis of the limbs may develop.

Cystic

Due to the formation of adhesions in the subarachnoid space, cysts are formed - cavities filled with cerebrospinal fluid. The main symptom of such arachnoiditis is persistent headaches accompanied by nausea and vomiting.

Adhesive

It is formed after an intense inflammatory process, leading to the connection of the arachnoid with the soft and dura mater. The numerous adhesions formed in this case disrupt the circulation of blood and cerebrospinal fluid, and both outflow and resorption (absorption) suffer. Accompanied by cephalgia, blurred vision, and severe weakness.

Post-traumatic

Occurs after head contusions, especially with subarachnoid hemorrhages. Typical signs sometimes reduced muscle tone, pathological reflexes in the extremities, changes in the fundus in the form of swelling, dilation of veins, narrowing of arteries.

Acute and chronic

If the disease begins suddenly, progresses quickly, and is accompanied by pronounced manifestations of inflammation according to test data, then such a course is considered acute. It is diagnosed extremely rarely, more often in weakened patients. Cerebral arachnoiditis usually has continuously increasing symptoms with periodic alternation of periods of exacerbation and remission.

Watch the video about cerebral arachnoiditis and its treatment:

Diagnostic methods

When examining patients, disorders of cranial innervation, neurological status, mental disorders and higher nervous activity are revealed. To do this, use the data obtained from:

• X-rays - signs of hypertension (indentation of brain tissue);
• Echo EG – hydrocephalus;
• EEG – foci of pathological activity;
• examination of the fundus - congestion in the area optic nerve, narrow fields of view;
• audiometry – decreased hearing;
• CT and MRI - adhesions, cysts, atrophy of brain tissue, help to exclude tumor, hemorrhage, accumulation of pus;
• cerebrospinal fluid analysis - increased protein, cells, neurotransmitters.

Treatment of inflammation of the arachnoid membrane of the brain

Depending on the cause and degree of activity of the inflammatory process, the treatment regimen may vary. The main groups of medications used for the disease:

• corticosteroid hormones (Metypred, Dexamethasone);
• absorbable (Lidaza, Bioquinol, Pyrogenal);
• anticonvulsants (Finlepsin, Keppra);
• (m, Lasix);
• neuroprotectors (Actovegin, Mildronate, Piracetam);
• antiallergic (Claritin, Tavegil);
• psychotropic – antidepressants and sedatives.

Sanitation of foci of infection is carried out using antibacterial therapy.

Severe arachnoiditis with a decrease in visual acuity or swelling of brain tissue due to impaired outflow is treated with surgery. They are carried out to restore the movement of fluid inside the skull - they separate adhesions, remove cysts, create alternative paths using shunting.

Consequences for the patient

More often, arachnoiditis is treatable and does not pose a threat to life, except for damage to the posterior cranial fossa with severe hydrocephalus. With frequent attacks of convulsions or increased blood pressure and loss of vision, a disability may be established:

• the third group with transfer to easier work if the patient cannot return to the previous one;
• the second group - for epileptic seizures, decreased visual acuity below 0.04 diopters with correction;
• first group - in case total loss vision.

There are professional contraindications for patients with previous cerebral or spinal arachnoiditis:

• high-altitude work,
• near a fire source,
• on transport,
• in cold or hot climates,
• with toxic compounds,
• working with vibration mechanisms.

Prevention

Careful treatment is necessary to prevent the disease viral infections and inflammatory processes in the ENT organs. After injuries, it is recommended to be examined by a neurologist at least 2 times a year. Those who have had a neuroinfection throughout the year should avoid mental, visual and emotional stress and undergo preventive courses of drug therapy as prescribed by a doctor.

Arachnoiditis is an autoimmune inflammatory process in the arachnoid region of the brain. It leads to the formation of cysts and adhesions that inhibit the outflow of fluid from the cranial cavity. Manifestations have a general cerebral origin (headache, vomiting, dizziness, convulsions) and focal signs - lesions of the eye and auditory nerve, impaired coordination of movements, skin sensitivity.

For treatment, complex drug therapy is used; if complications occur, surgery is indicated.

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Arachnoiditis - the main causes and clinical picture of the disease

Arachnoiditis in most sick people is detected several days or weeks after suffering from influenza, sore throat, acute pneumonia, sinusitis. Often the cause of the disease is syphilis, brucellosis, and inflammation of the middle ear. Arachnoiditis also occurs after traumatic brain injury, when inflammatory changes in the lining of the brain are affected. In fairly rare cases, cerebral arachnoiditis develops with endocrine pathologies and in cases of deep metabolic disorders.

The disease causes thickening of the arachnoid membranes, resulting in adhesions between the hard, soft and arachnoid membranes of the brain. Adhesive process forms a cyst filled with cerebrospinal fluid. Gradually, this cyst becomes denser and increases in size, which causes compression of different parts of the brain. Symptoms of arachnoiditis depend on where the cyst grows. Arachnoiditis can occur suddenly and then the characteristic clinical picture allows the doctor to quickly make a diagnosis. In some cases, arachnoiditis begins to manifest gradually and therefore its treatment begins already with a pronounced pathological process.

In addition to the characteristic signs of damage to different parts of the brain, there are also general symptoms indicating arachnoiditis, which usually include:

• Strong headache, increasing in the morning, when changing body position, due to changes in weather conditions.
• At the peak of pain, nausea and vomiting may occur.
• Patients often complain of dizziness and lightheadedness.
• Arachnoiditis causes the development of depression, anxiety, and disrupts sleep and performance.
• Skin sensitivity increases or, on the contrary, becomes dull.
• Over time, epilepsy attacks may occur.

The risk of damage to the membranes of the brain increases in people with weakened immune systems who have bad habits doing heavy physical labor. Arachnoiditis can be acute or chronic; treatment directly depends on the stage of development of the inflammatory process.

Classification of arachnoiditis

Arachnoiditis is usually classified by location, characteristic symptoms allow you to make a correct diagnosis even before full diagnostics begin symptomatic treatment.

Treatment requires preliminary diagnosis. The neurologist prescribes a skull x-ray, ultrasound, computed tomography. A complete neurological examination is performed.

Arachnoiditis - the main treatment

Treatment involves identifying the underlying cause.

• When otitis, sinusitis and other infectious diseases are detected, treatment must be carried out using antibiotics - Methicillin, Ampiox, Penicillin in average therapeutic doses.
• Reducing intracranial pressure is achieved through the use of diuretics - Furosemide, Lasix, Mannitol.
• Treatment is also carried out to restore the structure of damaged membranes. For this purpose, biogenic stimulants are prescribed - Aloe, vitreous.
• It is necessary to achieve resorption of adhesions - Lidaza and Pyrogenal are prescribed.
• At seizure symptoms Treatment is carried out with anticonvulsants.
• Depending on the identified symptoms, other symptomatic treatment is also used.

Arachnoiditis identified in acute stage, is quite successfully cured. But at the same time, the disease can develop into chronic form with exacerbation periods of different duration and symptoms. The first course of therapy is usually long and can last up to six months; after all the characteristic signs of the disease disappear, arachnoiditis and folk remedies.

Arachnoiditis - treatment with folk remedies

Treatment of arachnoiditis with folk remedies can improve blood circulation in different parts of the brain and relieve inflammation with painful attacks.

Arachnoiditis must be treated with both folk and medications under the full supervision of a neurologist. Periodic examination allows you to understand how the treatment of the disease is progressing.

Arachnoiditis is severe inflammatory disease arachnoid membrane of the brain or spinal cord. The symptoms of the pathology depend on its distribution in the brain and location. Arachnoiditis must be differentiated from asthenia, with which it has similar symptoms. Treatment of the disease involves complex conservative (drug) therapy. In the presence of serious complications the patient is assigned the first, second or third disability group.

Causes of arachnoiditis

In most patients with arachnoiditis, the predisposing factor is infectious diseases. In particular, these diseases include chickenpox, influenza, measles, viral meningitis, cytomegalovirus infection, meningoencephalitis. Chronic intoxication of the body can also provoke the disease, inflammatory diseases paranasal sinuses nose, injury. Arachnoiditis is often diagnosed in patients who experience reactive inflammation of a growing tumor.

Pathology can also arise due to acute or chronic purulent otitis. In this case, inflammation is provoked by toxins and low-virulent microbes. Researchers also include various complications of purulent otitis (petrositis, labyrinthitis, sinus thrombosis), brain abscess, and purulent meningitis and otogenic encephalitis.

In neurology, there are also a number of factors that are considered predisposing to the occurrence of the disease. Such factors include intoxication (for example, alcohol), frequent viral diseases, chronic overwork, hard work in an unfavorable climate, frequent injuries. In 10% of all cases of the disease, it is impossible to establish the exact etiology.

Pathogenesis of arachnoiditis

To understand the nature of the disease, it is necessary to become familiar with the anatomical features of the brain. The arachnoid membrane, which is affected by inflammation during arachnoiditis, is located between the soft and dura mater. Moreover, it is not fused with them, but simply fits tightly. Unlike the pia mater, the arachnoid membrane does not penetrate the cerebral convolutions. Small spaces filled with cerebrospinal fluid are formed under it.

All these spaces connect to the fourth ventricle. Through these spaces there is an outflow of cerebrospinal fluid from the cranial cavity. The mechanism of occurrence of arachnoiditis is as follows: due to exposure various reasons and provoking factors in the body, the production of antibodies to the arachnoid membrane is activated, which then provokes its inflammation. In patients with arachnoiditis, there is clouding and noticeable thickening of the arachnoid membrane, as well as the appearance of cystic expansions and connective tissue adhesions in it.

Classification of arachnoiditis

1. Arachnoiditis of the meninges

This type of disease is also called cerebral. Cerebral arachnoiditis is localized in the posterior cranial fossa, on the convex surface of the brain and its base. The clinical picture of this disease is characterized by regular headaches and impaired circulation of the cerebrospinal fluid. In the most severe cases, the disease is accompanied convulsive attacks, which can even lead to status epilepticus.

Arachnoiditis of the brain is often located in the central gyri and anterior parts of the cerebral hemisphere. Due to the resulting pressure on the sensory and motor centers, the patient may experience sensitivity and movement disorders. If the cerebral cortex is compressed or a cyst forms in it due to arachnoiditis, the patient may experience epileptic seizures.

2. Optico-chiasmatic arachnoiditis

This type of arachnoiditis is localized mainly in the chiasmal region. Common reasons the occurrence of this form of arachnoiditis are tonsillitis, malaria, syphilis, infectious diseases paranasal sinuses, traumatic brain injury. This type of arachnoiditis is characterized by the formation of adhesions in the area of ​​the intracranial part of the optic nerves and the chiasm. In the most difficult cases, a scar may form around the chiasm.

As a rule, the disease provokes vision problems in the patient. In this case, the degree of decrease in the patient’s vision can vary from its minimal decrease to blindness. In most cases of optochiasmatic arachnoiditis, patients experience optic nerve atrophy. Visual symptoms often strongly expressed, while hypertensive ones manifest themselves moderately.

3. Arachnoiditis of the posterior cranial fossa

It is the most common type of cerebral arachnoiditis. The severity of the symptoms of the disease depends on the location and nature of the inflammatory process, as well as its combination with hydrocephalus. The formation of cysts and adhesions usually leads to the closure of the openings of the cerebral ventricles, which provokes an increase in intracranial pressure. If intracranial pressure does not increase and is normal, the disease can last a long time.

For acute form The pathology is characterized by all the symptoms of high intracranial pressure: nausea, dizziness, vomiting, bradycardia, severe headache localized in the back of the head. With a less acute course of the disease, signs of damage to the posterior cranial fossa become most pronounced. Patients may also experience symptoms such as unsteady gait and spontaneous nystagmus.

4. Arachnoiditis of the spinal cord membranes

This is a spinal form of arachnoiditis, which occurs mainly due to purulent abscesses and furunculosis. Symptoms of the disease are similar to those of an extramedullary tumor: patients experience motor and sensory disorders, as well as radicular syndrome (limited mobility, parasthesia, trophic changes, pain in the heart, lower back and stomach, neck and limbs).

Spinal arachnoiditis is localized mainly at the level of the lumbar and thoracic segments, as well as on back surface spinal cord. Typically, arachnoiditis of the spinal cord membranes is chronic.

Symptoms of arachnoiditis

The first symptoms of the disease appear long after the exposure of the body to the provoking factor that caused its appearance. During this time, autoimmune processes occur in the patient's body.

The duration of this interval is directly related to which factor affected the body. For example, after a patient has had the flu, the first symptoms of arachnoiditis appear after a long period of time - from three to twelve months. After a traumatic brain injury, this period is reduced to 1-2 hours. At first, the patient is concerned about symptoms characteristic of asthenia: sleep disturbance, weakness, fast fatiguability, irritability. However, over time, more severe focal and cerebral symptoms of arachnoiditis may appear.

General cerebral symptoms of arachnoiditis

The cerebral complex of symptoms of cerebral arachnoiditis is characterized by liquor-hypertension syndrome. Most patients complain of a sharp headache, which is most active in the morning and can be aggravated by coughing, physical activity and straining. The consequences of increased intracranial pressure include such disorders as painful sensations when moving the eyes, vomiting, nausea, feeling strong pressure on the eyes.

Many patients turn to a neurologist with complaints such as decreased hearing, tinnitus, and attacks of dizziness. Therefore, during diagnosis, the doctor should exclude various diseases ear like labyrinthitis, chronic otitis, cochlear neuritis, adhesive otitis. It is also possible that symptoms characteristic of vegetative-vascular dystonia may appear.

Patients with arachnoiditis occasionally experience liquorodynamic crises - attacks of headache accompanied by vomiting, nausea and dizziness. Rare crises are considered to be attacks with a frequency of no more than 1-2 per month, average - 3-4 times, frequent - more than 4 times. Depending on the severity of symptoms during a crisis, it is divided into mild, moderate and severe form. The latter can last about two days.

Focal symptoms of arachnoiditis

Focal signs of the disease occur depending on its location. Convexital arachnoiditis is characterized by disturbances in the sensitivity and motor skills of the extremities of the lungs and moderate severity. More than 35% of patients with this form of arachnoiditis experience epileptic seizures. After the attack ends, the patient experiences a neurological deficit for some time.

Basilar arachnoiditis, which is localized in the optic-chiasmatic region, occurs with serious impairments of attention and memory, as well as a decrease in mental abilities. In addition, patients with this form of pathology complain of a significant decrease in visual acuity and other visual disturbances. In rare cases, opticochiasmatic arachnoiditis is accompanied by inflammation of the pituitary gland, which provokes endocrine-metabolic syndrome, the symptoms of which are similar to those of a pituitary adenoma.

Arachnoiditis of the posterior cranial fossa is characterized by very severe course. As a rule, patients show signs of neuritis of the facial nerve and neuralgia trigeminal nerve. Focal manifestations of arachnoiditis also include various cerebellar disorders: cerebellar ataxia, loss of coordination, nystagmus.

Diagnosis of arachnoiditis

Diagnosis of arachnoiditis involves comprehensive assessment neurologist features of the course of the disease and its clinical signs. One of important stages diagnostics is considered to be a history taking, during which the neurologist pays attention to the character and development of neurological symptoms, recent traumatic brain injuries of the patient and previous infections. A study of the neurological status is also carried out, which makes it possible to detect mnestic and psycho-emotional disorders, as well as neurological deficits.

Since arachnoiditis is characterized by visual and auditory disturbances, a neurologist may need to consult an ophthalmologist and otolaryngologist to conduct differential diagnosis. An otolaryngologist checks the degree and type of hearing loss using threshold audiometry. Determine the extent of damage auditory analyzer can be done using auditory evoked potentials, electrocochleography and acoustic impedance measurements.

Instrumental techniques such as skull radiography, electroencephalography and echo-encephalography are not considered sufficiently effective in diagnosing arachnoiditis, since they provide limited information about the presence of the disease in the patient. However, with their help you can detect some symptoms of pathology. For example, cranial radiography detects symptoms of prolonged intracranial hypertension, echo-encephalography detects hydrocephalus, and electroencephalography detects epileptic activity.

More information about the disease can be collected using MRI and CT scans of the brain. Both of these studies are used to identify morphological changes in the brain (atrophic changes, the presence of adhesions and cysts) and the nature of hydrocephalus. These techniques are also used to exclude tumors, hematomas and brain abscess. The doctor obtains accurate information about intracranial pressure by performing a lumbar puncture.

Treatment of arachnoiditis

The main goal of drug treatment for arachnoiditis is to eliminate the source of infection using antibiotics. The use of antihistamines and desensitizing medications (diazolin, histaglobulin, diphenhydramine, suprastin, pipolfen, tavegil, calcium chloride) is indicated. Drug therapy also provides for improved metabolism and local circulation, as well as normalization of intracranial pressure.

Patients who experience increased intracranial pressure are advised to take diuretics and decongestants (furosemide, mannitol, glycerin, diacarb). To eliminate convulsive syndrome, antiepileptic medications (carbamazepine, finlepsin, keppra) are used. According to indications, the doctor may prescribe drugs from the following drug groups:

• absorbable (rumalon, lidase, pyrogenal);
• antiallergic (loratadine, tavegil, diazolin);
• neuroprotectors and metabolites (mildronate, nootropil, ginkgo biloba);
• psychotropics (tranquilizers, antidepressants, sedatives).

Surgical intervention

If drug treatment does not produce the desired results, the patient experiences occlusive hydrocephalus or progressive vision loss, the doctor decides surgical intervention. During the operation, adhesions are separated and cysts are removed. To reduce the manifestations of hydrocephalus, shunt operations are prescribed.

The prognosis for the patient is often favorable. Only arachnoiditis of the posterior cranial fossa, which is almost always accompanied by occlusive hydrocephalus, can pose a great danger. With frequent relapses of the disease, epileptic seizures and its optico-chiasmatic form, the labor prognosis for the patient may worsen.

Prognosis for arachnoiditis

In most cases, patients with arachnoiditis receive the third disability group. However, if they have severe visual impairment and frequent epileptic seizures, they may be assigned a second disability group. The first disability group includes patients with opticochiasmatic arachnoiditis, which caused complete blindness. Work in transport, at heights, near fire, in noisy rooms, in unfavorable climatic conditions, and with toxic substances is contraindicated for patients with arachnoiditis.