Arachnoiditis of the meninges of the brain treatment. Causes and treatment of cerebral arachnoiditis

Autoimmune inflammatory lesion of the arachnoid membrane of the brain, leading to the formation of adhesions and cysts in it. Clinically, arachnoiditis is manifested by CSF-hypertensive, asthenic or neurasthenic syndromes, as well as focal symptoms (damage to the cranial nerves, pyramidal disorders, cerebellar disorders), depending on the predominant localization of the process. The diagnosis of arachnoiditis is established on the basis of anamnesis, assessment of neurological and mental status patient, echo-EG data, EEG, lumbar puncture, ophthalmological and otolaryngological examination, MRI and CT of the brain, CT cisternography. Arachnoiditis is treated mainly complex drug therapy, including anti-inflammatory, dehydration, antiallergic, antiepileptic, absorbable and neuroprotective drugs.

General information

Arachnoiditis posterior cranial fossa often has a severe course, similar to brain tumors of this localization. Arachnoiditis of the cerebellopontine angle, as a rule, begins to manifest itself as a lesion of the auditory nerve. However, it is possible to start with trigeminal neuralgia. Then symptoms of central neuritis of the facial nerve appear. With arachnoiditis of the large cistern, a pronounced cerebrospinal fluid-hypertensive syndrome with severe liquor-dynamic crises comes to the fore. Cerebellar disorders are characteristic: coordination disorders, nystagmus and cerebellar ataxia. Arachnoiditis in the area of ​​the large cistern can be complicated by the development of occlusive hydrocephalus and the formation of a syringomyelitic cyst.

Diagnosis of arachnoiditis

A neurologist can establish true arachnoiditis only after a comprehensive examination of the patient and a comparison of the anamnestic data, the results of a neurological examination and instrumental research. When collecting an anamnesis, attention is paid to the gradual development of symptoms of the disease and their progressive nature, recent infections or traumatic brain injuries. The study of the neurological status allows to identify disorders of the cranial nerves, to determine the focal neurological deficit, psycho-emotional and mnestic disorders.

Lumbar puncture provides accurate size information intracranial pressure. The study of cerebrospinal fluid with active arachnoiditis usually reveals an increase in protein up to 0.6 g / l and the number of cells, as well as increased content neurotransmitters (eg. serotonin). It helps to differentiate arachnoiditis from others cerebral diseases.

Treatment of arachnoiditis

Therapy of arachnoiditis is usually carried out in a hospital. It depends on the etiology and degree of disease activity. The drug treatment regimen for patients with arachnoiditis may include anti-inflammatory therapy with glucocorticosteroid drugs (methylprednisolone, prednisolone), absorbable agents (hyaluronidase, quinine iodobismuthate, pyrogenal), antiepileptic drugs (carbamazepine, levetiracetam, etc.), dehydration drugs (depending on the degree of increase intracranial pressure - mannitol, acetazolamide, furosemide), neuroprotectors and metabolites (piracetam, meldonium, ginkgo biloba, pig brain hydrolyzate, etc.), antiallergic drugs (clemastine, loratadine, mebhydrolin, hifenadine), psychotropics (antidepressants, tranquilizers, sedatives) . An obligatory moment in the treatment of arachnoiditis is the sanitation of existing foci of purulent infection (otitis media, sinusitis, etc.).

- This nervous system disease, in which there is inflammation of the soft membrane of the head or spinal cord with a predominant lesion of the arachnoid ( arachnoid) shells. An isolated lesion of the arachnoid true arachnoiditis) cannot be, since it lacks its own circulatory network. The long course of this pathology, if untreated, can lead to the formation of adhesions ( adhesions, partitions) and cyst ( cavity with contents). The most common arachnoiditis occurs in children and adults ( more often in men) up to 40 years.

Distinguish the following types arachnoiditis:

• cerebral arachnoiditis- is an inflammation of the soft membrane surrounding the brain;
• spinal arachnoiditis- is an inflammation of the soft membrane surrounding the spinal cord.

There are the following types of cerebral arachnoiditis(depending on location):

• convexital arachnoiditis- is an inflammation of the arachnoid membrane in the region of the cerebral hemispheres, which is accompanied by a violation of neurological symptoms ( convulsions, sensory disturbances);
• basal arachnoiditis- is an inflammation of the arachnoid membrane in the area of ​​\u200b\u200bthe base of the brain and is manifested by damage to the cranial nerves, impaired vision and some metabolic processes;
• optic-chiasmal arachnoiditis- is a type of basal arachnoiditis and is accompanied by various visual impairments ( decreased visual acuity and narrowing of visual fields) and color perception ( especially the perception of red and green);
• arachnoiditis of the cerebellopontine angle- is a type of basal arachnoiditis and is accompanied by headache ( in the occipital region), dizziness, tinnitus, vomiting, as well as lesions of the facial nerve;
• arachnoiditis of the posterior cranial fossa- accompanied by damage to the cranial nerves, impaired coordination of movements ( staggering when walking), headaches, impaired circulation of cerebrospinal fluid.

There are the following types of arachnoiditis(according to the mechanism of occurrence):

• adhesive arachnoiditis- is an inflammation of the arachnoid membrane of the brain, in which adhesions are formed ( adhesions), leading to impaired circulation of cerebrospinal fluid and the appearance of severe headaches;
• cystic arachnoiditis- is an inflammation of the arachnoid membrane of the brain, in which cavities are formed ( cysts);
• adhesive cystic arachnoiditis- develops as a result of inflammation of the membranes of the brain and their adhesion, while cysts form between the areas of adhesion.

The meninges are special membranes that cover the brain ( main body central nervous system ). These structures are located in the cranial cavity and separate the brain from the inner surface of the skull. Distinguish between the outer, middle and inner shells of the brain. Also, these membranes surround the spinal cord.

outer shell

outer meninges ( hard) is a dense whitish formation. It consists of an outer and an inner surface. The outer surface fits snugly to the bones of the skull. Inner surface is smooth, shiny and facing the middle shell. The inner surface forms several processes that pass into the deep cracks of the brain. The thickness of the outer shell is different and depends on which part of the brain it covers. hard shell, covering the upper part of the brain, has 0.7 - 1 mm. The hard shell covering the lower part of the brain is 0.1 - 0.5 mm. In some places it has splits ( bifurcation), which are called sines ( venous sinuses). In these formations, deoxygenated blood.

Middle shell

middle meninx ( arachnoid, arachnoid) is one of the three membranes that covers the brain and spinal cord and is a thin ( in the form of a web), transparent education. It is located between the other two meninges - the dura mater and the pia mater. Many branching fibers in the form of threads depart from the arachnoid ( trabeculae). These structures are woven into the pia mater, which is located under the arachnoid. On both sides, the middle meninges are covered nerve cells (glial cells). The space between the outer and middle shells is called the subdural space. It contains a special fluid ( cerebrospinal fluid). This liquid is a nutrient medium for the brain. Unlike the dura mater, the arachnoid does not penetrate into the cracks of the brain. It does not contain blood vessels.

Inner shell

Inner shell ( vascular, soft) is a structure that is located between the arachnoid membrane and the surface of the brain. It penetrates into all its cracks and furrows. The inner shell contains a large number of blood vessels that supply blood to the brain. The space between the arachnoid and choroid is called the subarachnoid ( subarachnoid) space. It contains approximately 120 - 140 ml of cerebrospinal fluid. In some places, this space forms significant extensions, which are called tanks.

There are following functions meninges:

• protective ( barrier) function- is the main function of the meninges, which provides protection of the brain from mechanical damage;
• circulatory function- the meninges promote blood circulation and nutrition of the brain;
• restrictive function separates parts of the brain from each other.

What happens in the arachnoid membrane of the brain during inflammation?

With inflammation of the arachnoid membrane of the brain, significant changes in its structure are observed. These changes occur under the influence of pathological microorganisms ( bacteria, viruses) and harmful substances, which they allocate ( toxins). These factors lead to damage to the structure of the middle meninges. In response to damage, special substances, the so-called inflammatory mediators, begin to be released. Under their influence, the arachnoid thickens and becomes much denser. It loses its transparency, becomes cloudy. Gradually, adhesions appear between the arachnoid, soft or hard shells ( adhesions). These structures interfere normal movement (circulation) cerebrospinal fluid. In addition, under the influence inflammatory process cerebrospinal fluid is produced in in large numbers (in excess). This liquid begins to stagnate. As a result of this process, bubbles are formed ( arachnoid cysts) of various sizes. Initially, they contain a clear liquid, which then becomes cloudy. These cysts become denser over time. They begin to put pressure on the brain and irritate its structures. These changes lead to significant consequences, which are manifested by a violation of the brain's performance.

Another mechanism for the formation of arachnoiditis is an autoimmune effect. In this case, the body attacks its own cells, including the cells of the meninges of the brain. Under the influence of autoimmune processes, special structures are formed ( antibodies), the action of which is directed against the cells of the arachnoid membrane. The result is swelling of the pia mater. The channels through which the cerebrospinal fluid flows are closed. This fluid accumulates and presses on the structures of the brain. As a result of these pathological processes, a corresponding clinic of such a disease as arachnoiditis arises.

Causes of arachnoiditis

Various past infections can contribute to the development of arachnoiditis ( acute or chronic), inflammatory diseases of the ENT organs ( ear, throat, nose), injury. In 10% of cases, it is not possible to establish the exact cause of the development of arachnoiditis. Factors contributing to the development of this pathology include various poisonings ( intoxication with lead, arsenic, alcohol), constant overwork, severe physical work in adverse conditions.

Causes of arachnoiditis

How is arachnoiditis treated for various pathologies?

Treatment of arachnoiditis can be medical or surgical and is usually carried out in a hospital ( in the hospital) in the Department of Neurology. The choice of treatment method depends on the cause of the disease and the degree of its activity ( manifestation of symptoms). Due to the fact that the clinical symptoms of the disease begin to appear after a sufficiently long period of time after exposure to a provoking factor, treatment should be aimed at improving the general condition and eliminating the symptoms that bother the patient at the moment. Special attention should be given to the prevention of progression of the disease and the prevention of the development of possible complications. In the complicated course of arachnoiditis ( progressive visual loss, hydrocephalus) can be shown surgical intervention. With adhesive arachnoiditis, absorbable drugs are prescribed ( lidase, rumalon, pyrogenal). With the development of convulsive attacks, treatment with anticonvulsants ( phenobarbital). In the case when the patient has an increase in intracranial pressure, diuretics may be prescribed, which help to remove excess fluid from the body.

Treatment of arachnoiditis

Alternative methods of treatment of arachnoiditis can be used in combination with drug treatment with uncomplicated disease. Arachnoiditis is a disease of the nervous system that requires specialist advice and the choice of appropriate treatment tactics. Before starting treatment with folk remedies, it is necessary to consult a doctor, since in addition to useful properties There are also contraindications that can aggravate the general condition of the patient. At severe course arachnoiditis and the presence of complications, alternative methods of treatment will be ineffective. In the absence of the effect of treatment with folk remedies or with the appearance of any adverse reactions you also need to see a doctor as soon as possible adequate treatment.

Lavender and honey

Need to collect lavender flowers ( reddish color) and fill the jar with them. A filled jar of flowers is poured with honey and left to infuse for 6 months in a dark, cool place. Stir the contents periodically. Six months later, the resulting mixture is taken one tablespoon three times a day. Lavender relieves vasospasm, helps reduce headaches, helps with convulsions. Honey has an anti-inflammatory effect and improves immunity.

St. John's wort, sage and motherwort

To prepare this collection, it is necessary to mix St. John's wort, sage and motherwort in equal proportions. After that, one tablespoon of the collection is poured with one liter of boiling water and insisted overnight ( in a thermos). In the morning you need to drink one glass of the resulting infusion. Drink the rest throughout the day. The course of treatment is one month. Then they take a break for several months and repeat the course. John's wort has anti-inflammatory and antispasmodic ( relieves spasm) action. Sage and motherwort have anti-inflammatory and antiseptic ( disinfecting) properties. Motherwort also helps to remove excess fluid from the body, thereby reducing pressure.

parsley root

It is necessary to dry the parsley root, and then grind it to a powder. One teaspoon of parsley powder is poured with a glass of boiling water and taken 3 times a day for 1/3 cup during a meal. Parsley root has anti-inflammatory, disinfecting ( antiseptic), bactericidal ( ), analgesic, anticonvulsant, restorative effect.

Lemon, garlic and honey

For cooking this tool it is necessary to pass a lemon through a meat grinder ( 5 items) and garlic ( 5 medium heads). Then mix and add about 500 grams of honey. The resulting remedy is taken four teaspoons after meals three times a day. Lemon, garlic and honey have bactericidal ( destroys pathogenic bacteria) properties and strengthens immune system.

Fir oil

With cerebral arachnoiditis, fir oil can help. It is necessary to rub the oil into the area of ​​the temples, forehead, crown and near the ears. After application to the skin, a slight tingling sensation may be felt for several minutes. Fir oil has anti-inflammatory, bactericidal ( destroys pathogenic bacteria), analgesic properties, and also has a tonic effect, increasing the body's defenses. The course of treatment lasts one month.

Aloe, elecampane, honey and wine

To prepare this decoction, you will need aloe leaves ( 150 grams), elecampane root ( 50 grams), Bee Honey ( 500 grams) and red wine ( 2 liters). To begin with, it is necessary to prepare gruel from aloe leaves, which is then mixed with elecampane roots. After that, bee honey, wine are added, mixed and boiled in a water bath for one hour. Before use, the broth is filtered and taken 1-2 tablespoons before meals ( 20 minutes before meals) 3 times a day. All ingredients provide healing effect and have anti-inflammatory, strengthening action.

Prevention of arachnoiditis is a complex medical task and consists in preventing the development of this pathology and possible complications. Since arachnoiditis can develop against the background of various diseases, intoxications and injuries, it is necessary to prevent their occurrence and eliminate the provoking factor in a timely manner.

There are the following methods of prevention of arachnoiditis:

• conducting healthy lifestyle life ( hardening, boosting immunity);
• regular visits to the doctor for a medical examination;
• early diagnosis and timely treatment of infectious diseases;
• prevention of infectious diseases avoid contact with infected people, vaccinate children);
• timely treatment of inflammatory diseases of the upper respiratory tract ( ear, throat, nose);
• increased caution when doing dangerous sports, being in a car in order to prevent traumatic brain injury;
• prevention of arachnoiditis with existing risk factors;
• timely prevention of recurrence ( recurrence of the disease).

Do they take with cerebral arachnoiditis in the army?

The diagnosis of cerebral arachnoiditis established by a neurologist is a serious reason for declaring a person unfit for military service. As a rule, patients with such a diagnosis are assigned a disability group. A disability group is assigned depending on the clinical symptoms and complications that may occur against the background of arachnoiditis. These complications include the development of hydrocephalus ( excess fluid in the brain), the occurrence of frequent epileptic ( convulsive) seizures, decreased visual acuity up to the development of blindness. Military service presupposes the presence of physical and mental health. The above complications can only aggravate the course of cerebral arachnoiditis and lead to irreversible consequences.

Initially, cerebral arachnoiditis can be manifested by increased fatigue, weakness, irritability, and sleep disturbances. Against this background, seizures may develop ( epileptic seizures). AT further disease progresses, and patients begin to feel a constant headache, pain in the eyes, tinnitus. Often cerebral arachnoiditis leads to disruption of the normal circulation of cerebrospinal fluid ( liquor), which can manifest as a sudden onset of headache, dizziness, nausea and vomiting.

Depending on localization location) cerebral arachnoiditis clinical manifestations can be very diverse. With this disease, motor activity may be impaired ( movement coordination) and tenderness in one or both lower extremities. There may also be impaired memory, attention, decreased mental performance. Some forms of arachnoiditis of the brain lead to a progressive decrease in visual acuity, hearing loss. Such patients are prohibited from serving in the army, since any adverse conditions ( climate, physical or emotional stress) can provoke a deterioration in the general condition of the patient. Patients with cerebral arachnoiditis should be regularly examined by a neurologist in order to stop the progression of the disease in time and prevent the development severe complications. As a rule, patients who have been diagnosed with arachnoiditis undergo an VTEK commission ( medical and labor expert commission), which establishes the presence of the disease, the causes of its development and the degree of disability. Accordingly, such patients cannot serve in the army.

What are the consequences of arachnoiditis of the brain?

In the absence of treatment of arachnoiditis of the brain, severe complications may develop. The most severe in this pathology are paresis or paralysis, the development of hydrocephalus, epilepsy and blindness.

Paralysis is the complete absence of voluntary ( independent) movements, loss of motor functions. Paresis is an incomplete loss of motor functions, a decrease in muscle strength. These complications occur against the background of spinal arachnoiditis, when nerve structures are involved in the process. This may be due to trauma to the spinal cord and its membranes in certain diseases ( spondylosis, osteochondrosis), tumors, after repeated manipulations near the spine ( epidural block, lumbar puncture).

Hydrocephalus is an excessive accumulation of cerebrospinal fluid ( liquor) in the brain. One of the reasons for the accumulation of fluid is a violation of its outflow due to the presence of adhesions ( adhesions) or cyst ( cavities), which can form with arachnoiditis of the brain. Another reason is excessive secretion ( production) cerebrospinal fluid and impaired absorption ( absorption). With the development of hydrocephalus, intracranial pressure increases, visual acuity gradually decreases. Hydrocephalus is also accompanied by constant headaches ( especially in the morning), nausea, vomiting ( bringing no relief). With a long course of this condition and the absence of the necessary treatment, pressure is exerted on the structures of the brain, which can lead to lethal outcome.

Epilepsy is a disease of the nervous system ( brain), which is characterized by the appearance sudden attacks convulsions ( epileptic seizures) and may be accompanied by loss of consciousness, the release of foam from the mouth. The development of this complication most often occurs with inflammation of the arachnoid membrane in the region of the cerebral hemispheres, that is, with convexital arachnoiditis. The triggering mechanism for the onset of epileptic seizures may be a recent brain injury. It is necessary to conduct a thorough diagnosis, since in some cases epileptic seizures may not be associated with the development of arachnoiditis.

Blindness is the complete loss of sight, the inability to see. This complication occurs, as a rule, with optic-chiasmatic arachnoiditis, when the optic nerve is damaged. Initially, with optic-chiasmal arachnoiditis, there is a gradual decrease in vision, narrowing of the visual fields, eye fatigue, color perception is disturbed ( especially difficult to distinguish between red and green). In the absence of timely adequate treatment, visual impairment progresses and can lead to the development of complete blindness.

How does spinal arachnoiditis manifest itself?

With spinal arachnoiditis, inflammation of the arachnoid membrane of the spinal cord occurs. Clinical manifestations ( symptoms) diseases appear after a certain period of time ( after a few months or more) after exposure to the provoking factor ( disease, poisoning, injury). This pathology is characterized by pain in the spine at the level pathological process (chest, lumbar ). At first, the pains are periodic, and then they are felt by the patient constantly. The first symptoms of spinal arachnoiditis are sensory disturbances in the extremities, weakening of tendon reflexes ( muscle contraction in response to stimulation). The patient may feel weakness and tingling in the legs, shooting pains. Sometimes the patient may feel numbness, muscle spasms (spontaneous twitches) in the lower extremities. In some cases, dysfunction of the pelvic organs may occur.

AT acute period diseases spinal arachnoiditis in addition to the above symptoms may manifest high temperature, changes in the blood and cerebrospinal fluid characteristic of inflammation ( liquor).

Spinal arachnoiditis can be combined with arachnoiditis of the brain. In this case, the clinical manifestations will depend on the location ( localization) pathological focus and the prevalence of the inflammatory process in the arachnoid membrane. Gradually developing symptoms spinal arachnoiditis, if left untreated, disrupt the usual way of life and lead to disability. It is very important to be examined in time, identify all the symptoms and start treatment on early stage diseases.

How does arachnoiditis manifest itself in children?

Clinical manifestations ( symptoms) arachnoiditis in children depend on localization ( location) of the pathological process. For arachnoiditis of the brain ( cerebral arachnoiditis) is characterized by the appearance of pain in the neck, back of the neck and pain in the eyes. Also, with this pathology, children complain of rapid fatigue, a constant feeling of weakness and heaviness in the head. On the background elevated temperature there is a headache, nausea, vomiting, dizziness. In severe cases, there is a progressive decrease in visual acuity ( up to total blindness), convulsions, loss of consciousness. Spinal arachnoiditis is characterized by the development of pain at the level of damage, impaired sensitivity and movement disorders.

Symptoms of arachnoiditis appear after a long period of time after exposure to a provoking factor and are complications of the underlying disease. It might be a few months later after infectious diseases) or even several years ( after traumatic brain injury). At the very beginning, the disease may manifest as fatigue, constant irritability ( psychoemotional disorders) and memory impairment. The child is disturbed by healthy sleep, and seizures of epilepsy may occur ( seizures). With a significant severity of the process and a long course of the disease in children early age (from 1 year to 3 years) there may be a delay mental development.

In the subarachnoid space ( between pia mater and arachnoid mater) due to inflammatory changes, adhesions are formed ( adhesions). In other cases, cysts may form ( cavities) of various sizes. All these changes disrupt the circulation of cerebrospinal fluid ( liquor) and lead to increased intracranial pressure ( intracranial hypertension ).

Is disability granted to those suffering from arachnoiditis?

Depending on the clinical manifestations, patients suffering from arachnoiditis are assigned a certain disability group. This is due to the fact that this pathology may cause disability. Disability is assigned to patients who experience frequent relapses ( return of disease after apparent recovery), epileptic seizures (convulsions), progressive deterioration of vision.

The following disability criteria are distinguished:

• 3rd disability group- is assigned to patients whose volume of production activity decreases when they are transferred to lighter work. Such patients need changes in working conditions due to the occurrence of hypertensive syndrome ( persistent increase in intracranial pressure).
• 2 disability group- assigned to patients who have progression of the disease, frequent exacerbations, persistent visual impairment ( decreased visual acuity and narrowing of visual fields). Also, in such patients, one can observe the frequent development of epileptic ( convulsive) seizures, violation vestibular function (movement coordination).
• 1 disability group- is assigned to patients who develop complete blindness or a significant decrease in hearing, visual acuity and a sharp narrowing of the visual fields. At the same time, patients cannot do without outside help, there is a limitation of the ability to orientation in space and self-service.

Patients with established diagnosis arachnoiditis, physical and neuropsychic overstrain is prohibited. Also, patients are contraindicated to work in adverse conditions ( noise, vibrations, contact with toxic substances, altered atmospheric pressure). Some patients ( with attacks of convulsions, attacks of impaired coordination of movements) it is forbidden to work near moving mechanisms, at a height, near a fire. In the case when the patient's vision is impaired, work associated with eye strain or requiring a clear distinction between colors is contraindicated.

Every year, patients who have been assigned a disability group must undergo a re-examination. In case of persistent and irreversible visual impairment after a five-year observation, a disability group is established without specifying the re-examination period. In the case of positive changes in the dynamics of the disease, a change in the disability group is possible.

What is the danger of smoking with arachnoiditis?

Smoking with arachnoiditis leads to aggravation of the patient's condition and irreversible changes in the brain. The nicotine contained in cigarettes affects not only the organs of the respiratory system, but also the organs that are damaged. In this case, such an organ is the brain, or rather its membranes. After 8 - 10 seconds after the start of smoking, nicotine reaches the brain, where it begins to exert its harmful effects. Smoking leads to spasm constriction) cerebral vessels. This leads to additional increase intracranial pressure, which is already present in arachnoiditis due to the formation of adhesions ( adhesions) and impaired circulation of the cerebrospinal fluid. Also, when smoking, blood circulation is disturbed, which leads to a violation of oxygen delivery and, accordingly, an insufficient supply of oxygen to the brain. Since the cells of the nervous system are the most sensitive to lack of oxygen, they are the first to respond to such changes, which leads to hypoxia ( oxygen starvation). With a long oxygen starvation develop intense headaches, memory impairment, impaired coordination of movements. Since these symptoms are observed with arachnoiditis and without smoking, in smokers their manifestation is even more pronounced.

Long-term smoking leads to a violation of the elasticity of the walls of blood vessels. They become less elastic and weak. Increased chance of cholesterol deposition atherosclerotic plaques) on the walls of blood vessels, which will further aggravate the blood supply to the brain. Smoking is a powerful poison that has a toxic effect not only on the brain, but also on other organs. In smokers with brain pathology ( cerebral arachnoiditis) the symptoms of the underlying disease are manifested to a greater extent, the disease progresses. More frequent development of complications and less effective results the treatment being carried out.

Arachnoiditis of the brain, the symptoms of which are not specific, is a complex inflammatory disease of the arachnoid membrane of the organ that develops against the background of an allergy, an autoimmune process, or a viral (bacterial) infection. Most often it occurs in young patients. Complex forms of the disease are accompanied by a violation of a person's ability to work and lead to disability.

There are several meninges: soft, arachnoid and hard. It is the middle of them that does not enter the part of the convolutions. Under this shell, spaces filled with cerebrospinal fluid are formed. For their association is the cavity of the fourth ventricle.

The arachnoid is not supplied with blood vessels. Thanks to her, the brain is fixed in the cranial cavity. This shell has a high degree permeability. If an infection, a virus appears in the human body, the brain is damaged due to trauma, then the arachnoid membrane becomes inflamed, arachnoiditis of the brain develops. She becomes thick, cloudy.

Accompanied by arachnoiditis cyst formation. Also, adhesions are fixed between the vessels and the shell, interfering with the circulation of the cerebrospinal fluid. Symptoms of the disease are general and focal. Often they depend on the type of disease.

The arachnoid membrane never suffers on its own, since there are no blood vessels in it. The inflammatory process often moves here from other parts of the brain. Arachnoiditis contributes to an increase in intracranial pressure, as a result of which dropsy of the brain develops. This complicates the diagnosis and treatment of pathology.

Reasons for the development of the disease

Cerebral arachnoiditis is most often provoked by a bacterial or viral infection. However, the cause of its development may be a brain injury. In general, the following causes of the disease can be distinguished:

• viral pathologies: chickenpox, measles, influenza;
• abscess or neoplasm in the brain;
• inflammatory processes: meningitis, encephalitis;
• diseases of the ear, throat, nose: sinusitis, tonsillitis, otitis;
• hemorrhage under the arachnoid;
• bruise or trauma to the brain (moreover, arachnoiditis in this case develops a few months later, when adhesions appear in the affected area);
• chronic intoxication of the body due to alcohol abuse, heavy metal poisoning;
• violation of the functionality of the endocrine system;
• a strong decrease in immunity;
• myelitis (its complications).

Other factors are also capable of provoking cerebral arachnoiditis: constant overwork, difficult working conditions. In some cases, the etiology of the disease remains unclear.

Classification and symptoms of the disease

There are several types of arachnoiditis:

1. True. The cause of this pathology is an autoimmune process or allergic reaction. Typically, this form of arachnoiditis is considered common, as it can affect the upper cellular layer of the cerebral cortex. This lesion is quite rare, in only 5% of cases of all diseases of the meninges.
2. Residual arachnoiditis is provoked by trauma or infection that has affected the nervous system. The result of this pathology is the appearance of adhesions and cysts filled with cerebrospinal fluid.

The disease can also be classified according to the predominant changes in the subarachnoid space:

1. Cystic arachnoiditis. Grow between the shells fibrous tissue, which provokes the formation of cavities filled with CSF.
2. Sticky. In this case, an effusion is formed, due to which loose adhesions develop. They interfere with the circulation of cerebrospinal fluid.
3. Mixed. This is a combination of symptoms and features of the two previous types of arachnoiditis.

If we take the localization of the pathology as the basis for the classification, then it happens:

1. Diffuse (extensive). It is diagnosed in most cases, since the inflammatory process extends to almost the entire membrane, and also affects neighboring tissues. The symptomatology is expressed vaguely. There are cerebral signs provoked by a violation of the circulation of the cerebrospinal fluid.
2. Limited. Such arachnoiditis is rare, because the arachnoid membrane does not have clear boundaries, so inflammation affects most of it.
3. Convexital. Arachnoiditis extends to that part of the membranes that is located on outer surface brain. Its course is considered to be easier. However, it is accompanied by epileptic seizures, disorders emotional sphere, paralysis and paresis.
4. Basal. It is localized at the base of the skull and affects the brainstem, nerves, and cerebellum. Here vision is disturbed, and from two sides. First, the fields of view change to some colors (red and green). In addition, an intense headache appears, the functions of the oculomotor nerves are disturbed. When examining the fundus, it shows atrophy of the optic nerve.
5. Posterior cranial fossa. There is a wide variety of symptoms here. With damage to the nerves of the skull, hearing loss, damage trigeminal nerve. If the inflammation affects the cerebellum, then there is a disorder of coordination and motor skills of movements. The patient also has a pronounced hypertensive syndrome.

The last classification parameter is the rate of development of the pathological process. Here are the types:

1. Spicy. If arachnoiditis develops very quickly, then the patient's temperature rises greatly, profuse vomiting appears. However, this form of pathology can be cured quickly, without serious consequences.
2. Subacute. Pathology is constantly progressing, then aggravating, then fading. With arachnoiditis of the brain, the symptoms increase slowly. First, asthenia, severe weakness and fatigue, moderate headache, problems with the emotional background, increased irritability appear.
3. Chronic. Over time, the inflammatory process progresses, and a person shows focal and cerebral signs. For example, the headache intensifies, nausea and vomiting are noted, and the eyes begin to hurt. The patient develops tinnitus, the tips of the fingers turn blue. He constantly wants to drink, there is a high sensitivity to bright light and loud sounds.

The patient often has sleep disturbances, memory disturbances, anxiety appears. There are other symptoms: sensitivity to weather changes, heavy sweating, excessive urination, loss of smell (complete or partial).

Features of diagnostics

Before starting treatment for arachnoiditis, the patient must be carefully examined to accurately determine the type of pathological process. For this, it is necessary to carry out the following studies:

• x-ray of the head (allows you to determine intracranial pressure, but is not considered a highly effective method);
• electroencephalography;
• echoencephalography;
• MRI or CT (the reliability of these methods is very high, because they allow not only to determine the presence and localization of cysts, but also their structure);
• lumbar puncture (makes it possible to determine the level of pressure of the cerebrospinal fluid);
• blood test (detects the presence of an inflammatory process in the body).

The patient will also need to consult an otolaryngologist and an ophthalmologist. The attending physician is obliged to collect a complete anamnesis, which should indicate whether the patient had injuries in the recent past, which chronic pathologies he has. Diagnosis should be differential, because the above symptoms can give other diseases (brain tumors).

Traditional treatment

Treated arachnoiditis in a hospital neurological department. In this case, not only medications are used, but also surgical methods therapy. The patient needs to take pills for a long time. The patient is prescribed the following drugs:

1. Antibacterial: Kanamycin. It is best to take newer drugs that are able to cross the blood-brain barrier. Antibiotics are used not only in the form of tablets. They can be injected into the lymph nodes located at the back of the neck.
2. Antiviral.
3. Antiallergic: "Dimedrol", "Claritin", "Suprastin".
4. Means for resorption of adhesions: Rumalon, Lidaza.
5. Diuretic: "Furosemide", "Diakarb" - are necessary with a strong increase in intracranial pressure in order to reduce the amount of fluid in the body.
6. Antiepileptic: "Finlepsin", "Carbamazepine". It may not be possible to completely get rid of this complication, but the patient's quality of life will be improved.
7. Steroid anti-inflammatory drugs: "Dexamethasone", "Prednisolone" - are used in acute forms of arachnoiditis. The courses of treatment with such drugs are short.
8. Neuroprotectors: Cerebrolysin, Nootropil.
9. Antidepressants and tranquilizers.
10. Vasodilator drugs: "Cerebrolysin", "Trental", "Kurantil" - will make it possible to improve blood circulation in the brain.

With an increase in intracranial pressure, the patient is given a solution of magnesium sulfate. Also applies intravenous administration potassium iodide. In order to eliminate adhesions and improve CSF circulation, air can be blown into the subarachnoid space. The use of antioxidants is also recommended.

Before using any drugs, it is imperative to find the source of infection. During the treatment of arachnoiditis of the brain, it is necessary to use means that strengthen the patient's immunity. Here you will need multivitamin complexes and a full menu.

If conservative therapy does not help, the attending physician prescribes surgical intervention. Most often, brain shunting, removal of adhesions and cysts is performed.

Features of folk therapy

You can treat arachnoiditis at home, but before that you need to consult a doctor. Naturally, the advanced stages of the disease cannot be eliminated with folk remedies. If the pathology has not yet gone too far, then the following recipes will be useful:

1. Burdock leaf. It must be tied to the head and changed every 24 hours. This plant will eliminate excess liquid in the skull.
2. Sequence flowers. After collecting the raw materials, it must be dried. Next 1 tbsp. l. plants are brewed with a liter of boiling water. It will take half an hour to insist. You need to drink such a kind of tea during the day. On the second day, it will no longer be so useful.
3. Turnip roots. After collection, they must be washed well and dried for fresh air. Further, the raw materials need to be ground through a meat grinder and grind into powder. It should be taken three times a day before meals, half a teaspoon. The course of treatment of the disease lasts 3 months.

Treatment with folk remedies does not give an immediate effect. It must be long and precise.

Prognosis, complications and prevention of the disease

If the treatment was chosen correctly for arachnoiditis, then the prognosis for life and health is favorable. However, this is not always the case. At wrong therapy arachnoiditis of the brain or a late visit to the doctor, pathology can deprive a person of his ability to work, make him disabled. For the patient, the areas of activity are significantly limited: he cannot climb to heights, work with movable mechanisms, drive vehicles, work in enterprises where there is a lot of noise, toxins, and low temperatures.

Arachnoiditis is an inflammatory disease of the arachnoid (arachnoid) membrane of the brain. The word "arachnoiditis" itself comes from the Greek language: arachne - web, eidos - view. The name of the disease was proposed by A. T. Tarasenkov in 1845. Synonyms: delimited adhesive meningopathy, chronic fibrosing leptomeningitis.

Arachnoiditis - special kind serous meningitis. When it occurs, the spaces for the outflow of cerebrospinal fluid stick together, which prevents the normal circulation of cerebrospinal fluid - it begins to accumulate inside the skull and compresses the brain, causing this dangerous state as hydrocephalus, increased intracranial pressure.

Symptoms

• Headache - especially in the morning.
• Dizziness, fainting.
• Insomnia.
• Depression, fear, anxiety, aggressiveness.
• Sensitivity to weather changes, often shivering, sometimes sweating.
• Dullness or increased skin sensitivity - a person does not feel touch, pain, heat, cold, or feels them very sharply.
• Signs of epilepsy.

Causes

The most common infectious arachnoiditis is caused by influenza, syphilis, acute pneumonia, tonsillitis, toxoplasmosis, brucellosis, throat diseases, ear inflammation, etc. Post-traumatic arachnoiditis often occurs after head or spine injuries. Also, the cause may be a tumor, epilepsy, osteomyelitis. Much less often, the disease is caused by metabolic disorders and various endocrine diseases. It happens that it is not possible to establish the exact cause for a long time.

With arachnoiditis, the arachnoid membrane of the brain thickens, becomes light gray in color, adhesions appear between the arachnoid and soft, hard shells. The adhesions form an arachnoid cyst filled with CSF. Over time, the cyst thickens and turns into a tumor, which increases in size and begins to put pressure on the brain.

Factors that increase the risk of inflammation of the arachnoid membrane of the brain:

• Acute infections - meningitis, meningoencephalitis.
• Acute purulent diseases sinusitis, tonsillitis, mastoiditis, otitis.
• Traumatic brain injury - even a closed injury is very dangerous, especially if it happens not for the first time.
• Chronic alcoholism.
• Harmful working conditions, hard physical labor.

Classification

• main feature classifications - localization of the inflammatory process - allocate cerebral and spinal arachnoiditis.
• If the membranes of the brain are affected - convexital, basal.
• According to the nature of the course of the disease - acute, subacute and chronic.
• According to the mechanism of occurrence - primary and secondary.
• Also isolated adhesive arachnoiditis, cystic and adhesive-cystic; unifocal and multifocal; diffuse and limited.
• Optic-chiasmal is post-traumatic arachnoiditis, which begins with a decrease in visual acuity in both eyes, is accompanied by optic neuritis, and can lead to multiple sclerosis.
• Basilar - occurs in 25% of cases, its focus is located in the anterior, middle cranial fossa. At the same time, serious mental deviations are observed - a decrease in concentration, forgetfulness, increased fatigue.

Cerebral arachnoiditis

With cerebral arachnoiditis, both general symptoms and focal ones are manifested. To general symptoms include: dizziness, headache, signs of epilepsy, nausea, vomiting. The very first symptom is a headache, at first common, then increasing. Attacks of severe headache provoke vomiting and dizziness. Changes in the fundus are possible. Focal symptoms: changes in skin sensitivity, anxiety, fear, nervous disorders.

Usually, arachnoiditis of the brain begins in an acute or subacute form after trauma, infection, and other causes already mentioned. The acute form can be completely cured, but often arachnoiditis becomes chronic - with normal temperature, periods of exacerbation and attenuation of symptoms. Severe cystic-adhesive arachnoiditis leads to a tumor, which makes the treatment prognosis unfavorable.

Adhesive cerebral arachnoiditis is very difficult to diagnose. The main symptoms - headache, dizziness, vomiting can indicate a variety of diseases. For identification it is necessary to carry out special diagnostic measures.

Convexital arachnoiditis - localized in the area central sulcus accompanied by epileptic seizures, severe headaches, diffuse changes biocurrents of the brain, etc.

Arachnoiditis of the posterior cranial fossa is a common and one of the most dangerous types of cerebral arachnoiditis. The cranial nerves are affected, the cerebrospinal fluid paths stick together, there are severe pains in the back of the head, which spread further - to the neck and back. Often in this case, trigeminal neuralgia and facial paralysis occur.

Spinal arachnoiditis

There are three types: adhesive, cystic or adhesive-cystic. The nature of the course of the disease can be single-focal or scattered, diffuse or limited.

Diffuse spinal - progressive movement disorders, sensory disturbances. The course of the disease is very diverse, usually the spinal cord and its membranes are affected. Echoes of meningitis are manifested in the form of Kernig's symptom and Brudzinsky's symptom.

Spinal limited adhesive arachnoiditis - often asymptomatic, resembling radiculitis by the nature of the lesion: intercostal neuralgia, sciatica, etc.

Cystic spinal - its manifestations are very similar to a tumor of the spinal cord. It is difficult for a person to move, there are severe back pains, as a rule, first on one side, then they pass to the entire back. CSF adhesions create pressure on the spinal cord, the so-called compression spinal syndrome is formed.

It occurs quite rarely in children, it accounts for approximately 2-3% of all diseases of the nervous system. Main causes: complications after pneumonia, influenza, otitis media, sinusitis, head trauma, spinal injury, etc.

Diagnostics

The following research methods are used for diagnosis:

• echoencephalography.
• Lumbar puncture.
• Craniography - X-ray examination of the skull.
• Pneumoencephalography.
• Contrast study of the spinal cord.
• Computed tomography, MRI.
• Examination of the fundus.
• Examination of the patient by an otolaryngologist to identify possible causes arachnoiditis.
• An examination by a psychiatrist to identify symptoms that are not visible at first glance, but are present in the patient.

Treatment

Treatment is carried out in a hospital. It is very important to carry out correct diagnosis and install true reason diseases. Next is assigned conservative treatment medical preparations:

• Prednisolone - 60 mg / day for 2 weeks.
• Drugs to reduce intracranial pressure.
• Antihistamines.
• Analgesics - for severe headaches.
• Preparations for stimulating the brain - cerebrolysin, etc.
• Means for the treatment of mental disorders - antidepressants, tranquilizers.
• If epileptic seizures are observed, they should also be treated with antiepileptic drugs.

Preparations are selected individually for each patient, depending on the type of arachnoiditis and the focus of its localization. Adhesive arachnoiditis is very successfully treated conservative methods, and for cystic ones, surgery is more effective. Surgery is usually indicated when medical treatment fails.

At timely treatment the prognosis is favorable. It is most difficult to treat arachnoiditis of the posterior cranial fossa, especially if cerebral dropsy has formed. After the operation, patients are given a disability (the disability group depends on the complications of the disease). Patients are prohibited from severe physical exercise, be in noisy rooms, drive public transport. It is possible to perform simple work outside the production workshops, without a long stay on the street or at height.

Prevention

• General prevention viral infections. Leading a healthy lifestyle.
• Timely treatment of emerging diseases of an infectious or traumatic nature.
• Complete diagnosis of arachnoiditis in closed craniocerebral injury.
• Regular visits to the otolaryngologist, ophthalmologist. In case of problems mental nature- Referral to a psychiatrist for examination.
• After successful treatment- prevention of relapses.

Arachnoiditis is a dangerous disease, which is characterized by the occurrence of an inflammatory process in the arachnoid (vascular) membrane of the brain and spinal cord. As a result of this process, pathological adhesions are formed between the arachnoid and pia mater of the GM. Such formations provide Negative influence on the brain, constantly irritating it, also because of their formation, the process of blood circulation of the brain and liquor circulation is disturbed. The name of this pathology came to us from the Greek language. It was first proposed for wide use by A. T. Tarasenkov.

Arachnoiditis is a special type of serous meningitis. If it begins to progress, then the spaces available in the body for the normal outflow of cerebrospinal fluid will gradually stick together. This will interfere with the physiological circulation of the CSF. As a result, it will accumulate in the cranial cavity and put a lot of pressure on the brain, provoking the development of such a dangerous condition for health and life as.

Causes

Most often, a person develops infectious arachnoiditis caused by and other pathologies. Often, patients develop post-traumatic arachnoiditis. It is the result of trauma to the head or spinal column. Also, the causes of the development of the pathological process can be malignant tumors, .

In more rare cases, the main cause of the progression of arachnoiditis is a metabolic disorder, as well as various diseases endocrine system. But there are also such clinical situations when the cause of the development of the pathology cannot be found out for a long time. It is important to conduct a thorough diagnosis in order to identify the main factor that provoked the development of the pathological process, and in the future to prescribe the correct course of treatment.

Factors that significantly increase the risk of progression of choroid inflammation:

• acute purulent ailments, such as tonsillitis, and so on;
• acute infections;
• chronic alcoholism;
• TBI - a closed skull injury is a great danger to human health;
• difficult working conditions;
• constant physical activity.

Kinds

Depending on the location of the pathological process, clinicians distinguish the following types of arachnoiditis:

Cerebral arachnoiditis

Cerebral arachnoiditis is a direct inflammation of the choroid of the GM. Most often, the focus of inflammation is formed on the convex surface of the brain, at its base or in the region of the posterior cranial fossa.

Characteristic symptoms are severe headaches, which tend to increase after a person has been in the cold for a long time, after physical and mental overstrain. Neurological symptoms pathologies directly depend on the location of the focus. If arachnoiditis has affected the convexital surface of the GM, then in this case the progression of convulsive seizures is possible.

If the treatment of cerebral arachnoiditis is not started in a timely manner, then generalized convulsive seizures may occur in the future, during which the person will lose consciousness. If the accumulated cerebrospinal fluid begins to put pressure on the sensory and motor centers of the brain, then the person will develop disorders motor activity and the sensitivity will decrease.

Optic-chiasmal arachnoiditis

Opto-chiasmal arachnoiditis is also often referred to as post-traumatic. As a rule, it develops due to TBI, against the background of progression, syphilis, tonsillitis. Such arachnoiditis of the brain, as a rule, is localized near the inner part of the optic nerves and chiasm. As a result of the progression of the pathology, adhesions and cysts form in these places.

If you conduct an examination at the moment, the doctor will be able to identify signs of stagnation and neuritis in the fundus area. Arachnoiditis of the posterior cranial fossa is the most common form of pathology. Are celebrated the following symptoms: nausea, vomiting, headaches, which are more pronounced in the occipital region.

Spinal arachnoiditis

In this case, inflammation of the choroid of the GM progresses due to abscesses, as well as injuries. As a rule, inflammation progresses along the posterior surface of the spinal cord. Symptoms of the disease can appear in a person some time after a previous injury. Pathology is characterized by the appearance pain in the upper and lower limbs.

Adhesive arachnoiditis

In the case of adhesive arachnoiditis develops purulent inflammation which leads to the formation of adhesions.

Cystic arachnoiditis

The inflammatory process is accompanied by the formation of a cyst. A characteristic symptom is severe and bursting headaches.

Cystic-adhesive arachnoiditis

The disease is characterized by the formation of pathological areas in the GM. In them, the choroid will adhere to the soft membrane, and adhesions and cysts will form. As a result, seizures may develop.

General symptoms

The following symptoms are also characteristic of the disease:

• weakness;
• increased fatigue;
• headaches, localized mainly in the occipital region and eyeballs. Pain tends to radiate;
• nausea;
• noise in ears;
• feeling of heaviness in the head;
• strabismus;
• decreased visual function;
• convulsions.

The severity of these symptoms directly depends on the location of the pathological process, as well as on the form of the disease. It is important at the first signs of arachnoiditis to immediately turn to qualified specialist, because untimely and not proper treatment can lead to the development of complications, disability or even death of the patient.

Diagnostics

This disease is very dangerous both for the health of the patient and for his life. Therefore, it is important at the first symptoms to immediately contact a medical institution for diagnosis. In this case, the following methods are used to confirm the diagnosis:

• examination of the fundus;
• echoencephalography;
• craniography;
• lumbar puncture;
• pneumoencephalography.

Complications and consequences

• a significant decrease in visual function;
• development of hydrocephalus;
• convulsive seizures.

Treatment

Treatment of the disease is carried out strictly in stationary conditions so that doctors can constantly monitor the patient's condition. Self-treatment at home with medicines or folk remedies is unacceptable. It is very important to diagnose in a timely manner and establish the main cause that provoked the development of the disease. Next, the doctor without fail prescribes conservative treatment with the help of synthetic medicines:

• prednisolone. This drug administered to the patient for 14 days;
• antihistamines;
• drugs that help reduce intracranial pressure;
• tranquilizers;
• antidepressants;
• in the presence of severe pain syndrome, painkillers are prescribed;
• drugs that stimulate the brain;
• if the patient has developed epileptic seizures, then in this case, antiepileptic drugs are indicated.

All means for conservative therapy are selected by the doctor strictly individually, taking into account the characteristics of his body, the type of arachnoiditis and the focus of its localization. Conservative therapy allows you to completely cure a person from adhesive arachnoiditis. If a cystic form of the pathology has developed, then the most rational method of treatment will be surgical intervention. Also, this method is used if conservative therapy is ineffective.

If the correct treatment is carried out in time, then all the symptoms of the disease will soon go away and the person will fully recover. In this case, the prognosis will be favorable. The most difficult thing is to cure a patient from arachnoiditis of the posterior cranial fossa, especially in the case of the formation of dropsy of the brain. The only true way of treatment is an operation. After it, the patient, as a rule, is given a disability. Patients are not allowed to stay in noisy rooms for a long time, loads and driving public transport are prohibited.

Prevention

• timely treatment of ailments of an infectious nature;
• infection prevention;
• careful diagnosis of arachnoiditis, if TBI was previously obtained;
• preventive visits to the ophthalmologist and otolaryngologist. This is necessary to prevent the development of inflammatory diseases that can cause the development of arachnoiditis;
• when the first symptoms appear, you should immediately consult a doctor to diagnose and treat the pathology, because the sooner this is done, the more favorable the prognosis will be. Treatment should be carried out only in stationary conditions. Self-treatment is strictly prohibited!

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