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A case of superficial siderosis ameliorated after closure of dural deficit detected by MRI-CISS (constructive interference in steady state) imaging.

Abstract A 64-year-old male developed headache, dizziness, and difficulty hearing, two years after an operation for chronic subdural hematoma due to head injury. These symptoms gradually worsened over the following 15 years. As he showed bloody cerebrospinal fluid (CSF) and marginal hypointensity on the surface of the brain and spinal cord on T2/T2*-weighted MRI, he was diagnosed with superficial siderosis (SS), although the source of the bleeding was unclear and anti-hemorrhagic drugs were ineffective. When he was admitted to our hospital, neurological examination disclosed horizontal gaze-evoked nystagmus, severe bilateral hearing loss, scanning speech, and limb and truncal ataxia. CISS (constructive interference in steady state) MRI detected a dural defect at the Th2-3 level on the anterior side of the spinal canal. On operation, a 2 mm × 6 mm size dural defect with blood clots was found at the Th2-3 level. After closure of the dural defect, bloody CSF became transparent, and his persistent headache, dizziness, and hearing impairment improved. Brain and whole spine MRI, especially CISS imaging, should be considered for detecting the source of bleeding in intractable cases of SS.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title rinsho shinkeigaku = clinical neurology
Publication Year Start




PMID- 28367945
OWN - NLM
STAT- Publisher
DA  - 20170403
LR  - 20170403
IS  - 1882-0654 (Electronic)
IS  - 0009-918X (Linking)
DP  - 2017 Mar 30
TI  - A case of superficial siderosis ameliorated after closure of dural deficit
      detected by MRI-CISS (constructive interference in steady state) imaging.
LID - 10.5692/clinicalneurol.cn-000960 [doi]
AB  - A 64-year-old male developed headache, dizziness, and difficulty hearing, two
      years after an operation for chronic subdural hematoma due to head injury. These 
      symptoms gradually worsened over the following 15 years. As he showed bloody
      cerebrospinal fluid (CSF) and marginal hypointensity on the surface of the brain 
      and spinal cord on T2/T2*-weighted MRI, he was diagnosed with superficial
      siderosis (SS), although the source of the bleeding was unclear and
      anti-hemorrhagic drugs were ineffective. When he was admitted to our hospital,
      neurological examination disclosed horizontal gaze-evoked nystagmus, severe
      bilateral hearing loss, scanning speech, and limb and truncal ataxia. CISS
      (constructive interference in steady state) MRI detected a dural defect at the
      Th2-3 level on the anterior side of the spinal canal. On operation, a 2 mm x 6 mm
      size dural defect with blood clots was found at the Th2-3 level. After closure of
      the dural defect, bloody CSF became transparent, and his persistent headache,
      dizziness, and hearing impairment improved. Brain and whole spine MRI, especially
      CISS imaging, should be considered for detecting the source of bleeding in
      intractable cases of SS.
FAU - Sakoda, Ayako
AU  - Sakoda A
AD  - Department of Neurology, Neurological Institute, Graduate School of Medical
      Sciences, Kyushu University.
FAU - Yamashita, Ken-Ichiro
AU  - Yamashita KI
FAU - Hayashida, Mitsumasa
AU  - Hayashida M
FAU - Iwamoto, Yukihide
AU  - Iwamoto Y
FAU - Yamasaki, Ryo
AU  - Yamasaki R
FAU - Kira, Jun-Ichi
AU  - Kira JI
LA  - eng
PT  - Journal Article
DEP - 20170330
PL  - Japan
TA  - Rinsho Shinkeigaku
JT  - Rinsho shinkeigaku = Clinical neurology
JID - 0417466
EDAT- 2017/04/04 06:00
MHDA- 2017/04/04 06:00
CRDT- 2017/04/04 06:00
AID - 10.5692/clinicalneurol.cn-000960 [doi]
PST - aheadofprint
SO  - Rinsho Shinkeigaku. 2017 Mar 30. doi: 10.5692/clinicalneurol.cn-000960.

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