The symposium is co-organised by The Ann Conroy Trust, in association with Aesculap Academia.
The Ann Conroy Trust is Registered Charity No: 1165808.
We provide Support, Education and Research for patients living with Chiari Malformation, Syringomyelia and associated conditions.
F13 Arachnoid webs: clinical and radiological outcomes.
Chawira A, Buxton N, Pigott T, Brodbelt AR.
Arachnoid webs can be challenging to diagnose. The aim of this retrospective, single-centre study was to examine clinical and radiological outcomes in symptomatic patients undergoing arachnoid band division surgery between 2007 and 2017.
1046 patient operative records were examined. 15 patients (4 female, 11 male) met the inclusion criteria. An examination of notes, images, and operative reports was conducted. Clinical outcome was stratified into ‘worse’, ‘same’, or ‘better’.
Median age was 62 years (range 26-84). Median radiological follow-up was 6 years and median clinical follow-up was 2 years. Median duration of pre-operative symptoms was 31 months (range 4-288). Arachnoid bands were identified on myelography or on MRI and confirmed intra-operatively. In the follow-up period, 6 patients (4 in 10) demonstrated a reduction in the volume of their syrinx based on sagittal T2-weighted MR images, with 8 patients (just over half) experiencing either improvement in their symptoms or stability post-operatively. Radiological improvement or stability was observed in 12 patients and was associated with clinical improvement in 3 cases, stability in 4 and worsening in 5 cases.
Arachnoid webs can be difficult to diagnose and a high index of suspicion is required. Patients with imaging evidence of syrinx improvement may continue to deteriorate. A better understanding of the pathophysiology may help to improve outcome.