A aracnoidite (ARC) é uma inflamação crônica da camada aracnóide das meninges, da qual a aracnoidite adesiva é a forma mais grave, caracterizada por dor neurogênica debilitante e intratável nas costas e nos membros e uma série de outros problemas neurológicos.
Introdução
O que você precisa saber de cara
A aracnoidite (ARC) é uma inflamação crônica da camada aracnóide das meninges, da qual a aracnoidite adesiva é a forma mais grave, caracterizada por dor neurogênica debilitante e intratável nas costas e nos membros e uma série de outros problemas neurológicos.
Escala de raridade
<1/50kMuito rara
1/20kRara
1/10kPouco freq.
1/5kIncomum
1/2k
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Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Partes do corpo afetadas
+ 9 sintomas em outras categorias
Características mais comuns
Os sintomas variam de pessoa para pessoa. Abaixo estão as 18 características clínicas mais associadas, ordenadas por frequência.
Linha do tempo da pesquisa
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Genética e causas
O que está alterado no DNA e como passa nas famílias
Nenhum gene associado encontrado
Os dados genéticos desta condição ainda estão sendo catalogados.
Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — Aracnoidite adesiva
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Dados de DATASUS/CNES, SBGM, ABNeuro e Ministério da Saúde. Sempre confirme a disponibilidade diretamente com o estabelecimento.
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Pesquisa e ensaios clínicos
6 ensaios clínicos encontrados.
Publicações mais relevantes
Case Report: Spinal cord stimulation for neuropathic pain from spinal cysticercosis.
Spinal cord cysticercosis, an exceptionally rare form of neurocysticercosis (NCC), often leads to refractory neuropathic pain and neurological deficits. Current treatments (e.g., antiparasitics or decompressive surgery) may fail to alleviate symptoms, necessitating alternative strategies. Spinal cord stimulation (SCS) is well-established for chronic pain but has rarely been reported for NCC-related pain. A 69-year-old female presented with an 8-year history of progressively worsening trunk and limb pain (burning sensation, VAS 8/10), sensory abnormalities, and lower limb weakness (MMT 3/5). She had undergone laminectomy for spinal cysticercosis in South Korea, but pain persisted post-operatively. MRI revealed residual cystic lesions with arachnoiditis at T12-L2, consistent with inactive spinal cysticercosis. Electromyography confirmed mixed sensorimotor polyneuropathy. After multidisciplinary evaluation, a percutaneous SCS electrode was implanted at T10. Intraoperative testing achieved 80% pain coverage. Parameters were titrated post-operatively (frequency: 40 Hz, pulse width: 300 μs). At the 1-week follow-up, the patient reported significant pain relief, with her visual analog scale score dropping to 2 out of 10. Motor strength improved to grade 4 out of 5 on manual muscle testing, and sensory function returned to normal. These benefits persisted at the 3-month follow-up, accompanied by a 75% reduction in opioid requirements, measured in morphine milligram equivalents. SCS may be a viable option for spinal cysticercosis-induced central neuropathic pain when conventional therapies fail. Its dual benefits (pain relief + functional recovery) warrant further study in NCC-related complications. Early SCS intervention could prevent chronic disability in similar cases.
Chronic spinal meningitis: a forgotten condition revisited through a case series and literature review.
Chronic spinal meningitis, marked by inflammation of the spinal cord's meninges, poses significant diagnostic and therapeutic challenges, particularly when the cause remains unidentified. This case series reviews four patients presenting with chronic spinal meningitis, showcasing diagnostic strategies, clinical courses, and management difficulties. The study highlights the need for a comprehensive, multidisciplinary approach involving neurologists, infectious disease experts, and rheumatologists. Despite advances in imaging and cerebrospinal fluid (CSF) analysis, definitive diagnosis often remains elusive. Cases progress to complications such as hypertrophic spinal pachymeningitis and spinal adhesive arachnoiditis, which may lead to severe long-term sequelae. A detailed analysis of each patient demonstrated the complexities of differential diagnosis, with conditions ranging from infectious and autoimmune disorders to carcinomatous meningitis. This series emphasizes the necessity of heightened clinical awareness, comprehensive diagnostic approaches, and further research to address the knowledge gap in chronic spinal meningitis and improve patient outcomes through timely intervention.
Identification of BRAF V600E Mutation in Cerebrospinal Fluid Aids in Diagnosing Leptomeningeal Carcinomatosis Arising From Pleomorphic Xanthoastrocytoma: A Case Report.
Pleomorphic xanthoastrocytomas (PXAs) are rare primary central nervous system (CNS) tumors that appear heterogeneous on imaging and histology and typically cause headaches or seizures on initial presentation. Alongside high rates of favorable prognosis after surgical excision exist similarly high rates of recurrence. Leptomeningeal spread on recurrence is even rarer and more challenging to diagnose. We describe a case of a 40-year-old man with a history of surgically resected PXA presenting 12 years later with persistent headaches and lower back pain. Imaging studies revealed arachnoiditis, and a subsequent brain biopsy was nondiagnostic. Serial CSF studies only revealed the presence of atypical cells too few to further characterize via standard histology studies, with rare small lymphocytes and monocytoid cells. Submitting these cells for next-generation sequencing ultimately revealed a BRAF V600E mutation typically found in PXAs, thereby confirming the diagnosis of leptomeningeal recurrence and revealing a therapeutic target. This case highlights the utility of next-generation sequencing as a means of non-invasively diagnosing leptomeningeal disease in recurrent PXA and potentially in other cancer types as well.
Successful Control of Refractory Coccidioides Meningitis With MAT2203.
Coccidioides meningitis is a life-threatening complication with Coccidioides spp that requires lifelong antifungal therapy. While some cases respond to azoles, others are refractory and require periodic treatment with intravenous and/or intrathecal (IT) amphotericin B. MAT2203 is a novel formulation of amphotericin B that uses a rolled phosphatidylserine lipid nanocrystal bilayer that is orally absorbed. MAT2203 has been successfully used to treat cryptococcal meningitis and Histoplasma meningitis. In 2017 a previously healthy construction worker developed coccidioidal pneumonia and meningitis and was treated with liposomal amphotericin B and oral fluconazole. His pneumonia resolved, but his meningitis worsened. Imaging showed vasculitis of his middle cerebral artery and arachnoiditis at the base of the brain and eventually throughout his spine. He required multiple changes in azoles and eventually an Ommaya reservoir so that he could receive periodic IT amphotericin B plus corticosteroids while continuing oral isavuconazole. Treatment response was monitored with symptoms, cerebral spinal fluid (CSF) cell counts, CSF Coccidioides antigen, and imaging. Frequency of IT treatment varied over the course of his illness from 3 times per week to monthly, increasing with symptom flares. A trial of the investigational antifungal olorofim also failed. In 2024, 1 month after his last dose of IT amphotericin B, the patient started treatment with MAT2203. After 6 months of MAT2203 (without any IT or intravenous amphotericin B), Coccidioides antigen in the ventricular CSF was undetectable for the first time and remained so with normalization of glucose and cell counts. MAT2203 may offer an oral therapeutic option for refractory cases of Coccidioides meningitis.
Fatal arachnoiditis following accidental intradural injection of chlorhexidine: a case report and literature review.
Chlorhexidine is the preferred antiseptic for skin preparation owing to its superior antimicrobial efficacy compared with povidone-iodine. However, its supposed neurotoxicity-particularly in combination with alcohol-can cause catastrophic damage if inadvertently introduced into the neuraxial space during epidural or spinal anesthesia. We describe a fatal case of arachnoiditis following unintentional intradural injection of alcohol-based chlorhexidine during epidural catheter placement for labor analgesia and report a literature review. Among 114 records, five case reports met the inclusion criteria. All patients were women receiving epidural or spinal anesthesia for obstetric or surgical procedures. Exposure involved either direct injection or contamination of anesthetic solutions with chlorhexidine. Onset ranged from immediate lumbar pain to delayed neurological deterioration. Reported outcomes included paraplegia, tetraplegia, hydrocephalus, syringomyelia, and profound functional loss. Therapeutic interventions-corticosteroids, neurosurgery, cerebrospinal fluid shunting, and analgesia-were ineffective in reversing deficits. Error prevention is essential and relies on the use of colored solutions, strict physical separation between chlorhexidine and other solutions used during procedures, the use of pre-impregnated applicators, or alternatively the use of naturally colored povidone-iodine, which may be less neurotoxic. Accidental intradural or epidural administration of chlorhexidine is a rare but devastating event most often associated with poor outcomes. Prevention requires mandating colored antiseptics or enforcing strict handling protocols.
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Identification of BRAF V600E Mutation in Cerebrospinal Fluid Aids in Diagnosing Leptomeningeal Carcinomatosis Arising From Pleomorphic Xanthoastrocytoma: A Case Report.
Case Report: Spinal cord stimulation for neuropathic pain from spinal cysticercosis.
Successful Control of Refractory Coccidioides Meningitis With MAT2203.
Fatal arachnoiditis following accidental intradural injection of chlorhexidine: a case report and literature review.
Adverse effects associated with intrathecal chemotherapy for leptomeningeal disease.
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Drug discoveries & therapeuticsTwo Cases of Miliary and Disseminated Coccidioidomycosis Following Glucocorticoid Therapy and Literature Review.
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Journal of pediatric hematology/oncologyCNS cryptococcosis presenting with cerebellar stroke and spinal arachnoiditis.
BMJ case reportsIncidental finding of arachnoiditis ossificans in the lumbar spine.
ANZ journal of surgeryA new surgical method for treating syringomyelia secondary to arachnoiditis following cervical spine surgery: the syringo-cisterna magna shunt.
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research SocietySyringo-peritoneal Shunt for Syringomyelia Due to Extensive Adhesive Arachnoiditis: A Case Report.
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BMJ case reportsVenous congestion as a central mechanism of radiculopathies.
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Journal of neurosurgery. SpineArachnoiditis Ossificans in the Thoracic Spine With Associated Cyst and Syringomyelia: A Rare, Intraoperative Finding Complicating Dural Opening.
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Tuberculosis (Edinburgh, Scotland)Subdural fluid collection rather than meningitis contributes to hydrocephalus after cervical laminoplasty: A case report.
World journal of clinical casesSpinal Arachnoiditis Ossificans: A Case-Based Update.
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Asian journal of neurosurgeryA Case of Sellar/Suprasellar Neurocysticercosis Mimicking a Craniopharyngioma.
Asian journal of neurosurgeryImmunotherapies in chronic adhesive arachnoiditis - A case series and literature review.
eNeurologicalSciArachnoiditis following epidural blood patch-An avoidable rare complication due to blind technique.
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Eye (London, England)Arachnoiditis following epidural blood patch-An avoidable rare complication due to blind technique: A response.
HeadacheImaging Assessment of the Postoperative Spine: An Updated Pictorial Review of Selected Complications.
BioMed research internationalIncidence of dural sac puncture during neuraxial anesthesia in cats: an observational, retrospective study.
Journal of feline medicine and surgeryPerspective: Early diagnosis and treatment of postoperative recurrent cerebrospinal fluid fistulas/ dural tears to avoid adhesive arachnoiditis.
Surgical neurology internationalCerebellar Syringocephaly Following Surgery for Chiari Malformation.
NeurologyAssessment of main complications of regional anesthesia recorded in an acute pain unit in a tertiary care university hospital: a retrospective cohort.
Brazilian journal of anesthesiology (Elsevier)MRI characteristics of syringomyelia associated with foramen magnum arachnoiditis: differentiation from Chiari malformation.
Acta neurochirurgicaHydrocephalus in Mexican children with Coccidioidal Meningitis: Clinical, serological, and neuroimaging findings.
Surgical neurology internationalManagement of syringomyelia associated with tuberculous meningitis: A case report and systematic review of the literature.
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia[Arachnoiditis following spinal anesthesia-Case report and review of the literature].
Der AnaesthesistBacterial meningitis and COVID-19: a complex patient journey.
BMJ case reportsMRI Findings of Arachnoiditis, Revisited. Is Classification Possible?
Journal of magnetic resonance imaging : JMRIMRI findings in tubercular radiculomyelitis.
eNeurologicalSciSpinal Syrinx Due to Lipiodol-Induced Arachnoiditis.
World neurosurgeryArachnoiditis, a complication of epidural blood patch for the treatment of low-pressure headache: A case report and systematic review.
Headache[Treatment of syringomyelia in patients with arachnopathy within craniovertebral junction].
Zhurnal voprosy neirokhirurgii imeni N. N. BurdenkoThe Pathogenesis of Neurotrauma Indicates Targets for Neuroprotective Therapies.
Current neuropharmacologyReintervention rate of arachnolysis versus shunting for nonforaminal syringomyelia.
Journal of neurosurgery. SpineSpondylotic and Other Structural Myelopathies.
Continuum (Minneapolis, Minn.)Arachnoiditis Ossificans of the Lumbar Spine: A Rare Cause of Progressive Cauda Equina Syndrome.
World neurosurgeryCerebral Vasculopathy and Spinal Arachnoiditis: Two Rare Complications of Ventriculitis Post Subarachnoid Hemorrhage.
CureusNeurotuberculosis: an update.
Acta neurologica BelgicaFXTAS presents with upregulation of the cytokines IL12 and TNFα.
Parkinsonism & related disordersThalidomide Use for Complicated Central Nervous System Tuberculosis in Children: Insights From an Observational Cohort.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of AmericaOperative findings and outcome of microvascular decompression/adhesiolysis for trigeminal neuralgia in multiple sclerosis without demyelinating brain stem lesions.
Clinical neurology and neurosurgeryEndoscopic Transfontanellar Approach of a Cyst Anterior to the Brainstem Crossing the Foramen Magnum-Part I: Failure of Unique Fenestration: 2-Dimensional Operative Video.
World neurosurgerySpinal arachnoiditis leading to recurrent reversible myelopathy: A case report.
The journal of spinal cord medicineEndoscopic Excision of Intraventricular Neurocysticercosis Cyst with an Angiocatheter: A Retrospective Analysis.
Asian journal of neurosurgeryTuberculous optochiasmatic arachnoiditis & myeloradiculopathy.
The Indian journal of medical research"Malignant" Craniospinal Neurocysticercosis: A Rare Case.
World neurosurgeryComplications associated with lumbar drain placement for endovascular aortic repair.
Journal of vascular surgeryAncient foe, serious weapon: Subarachnoid hemorrhage secondary to TB meningitis.
IDCasesAssociações
Organizações que acompanham esta doença — pra ter apoio e orientação
Ainda não temos associações cadastradas para Aracnoidite adesiva.
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Comunidades
Grupos ativos de quem convive com esta doença aqui no Raras
Ainda não existe comunidade no Raras para Aracnoidite adesiva
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- Case Report: Spinal cord stimulation for neuropathic pain from spinal cysticercosis.
- Chronic spinal meningitis: a forgotten condition revisited through a case series and literature review.
- Identification of BRAF V600E Mutation in Cerebrospinal Fluid Aids in Diagnosing Leptomeningeal Carcinomatosis Arising From Pleomorphic Xanthoastrocytoma: A Case Report.
- Successful Control of Refractory Coccidioides Meningitis With MAT2203.
- Fatal arachnoiditis following accidental intradural injection of chlorhexidine: a case report and literature review.
- Adverse effects associated with intrathecal chemotherapy for leptomeningeal disease.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:137817(Orphanet)
- MONDO:0015304(MONDO)
- GARD:5839(GARD (NIH))
- Busca completa no PubMed(PubMed)
- Q2669284(Wikidata)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar
