Unilateral radiculopathy away from the puncture site due to adhesive arachnoiditis after spinal anesthesia for an emergent cesarean delivery: a case report.
JA Clin Rep 2022;
8:28. [PMID:
35412174 PMCID:
PMC9005567 DOI:
10.1186/s40981-022-00518-3]
[Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 03/31/2022] [Accepted: 04/03/2022] [Indexed: 12/03/2022] Open
Abstract
Background
Adhesive arachnoiditis has been described as a deteriorating neurological complication after neuraxial blockade; however, few pieces of literatures have reported minor cases that resemble peripheral neuropathy.
Case presentation
A 29-year-old nulliparous woman underwent an emergent cesarean delivery under spinal anesthesia at the second and third lumbar interspace (L2/3) without any specific concerns. Subsequently, she developed left L5 and sacral first (S1) radiculopathy that persisted for 2 months. Although the neurological findings more likely indicated peripheral neuropathy, magnetic resonance imaging revealed localized adhesive arachnoiditis at the left L5/S1 level. Her symptoms gradually improved and entirely disappeared within 2 months without any particular treatment.
Conclusion
The neurological symptoms that show a clear tendency to improve spontaneously do not always undergo a detailed workup. Therefore, such minor adhesive arachnoiditis might have occurred more than expected. Imaging such cases might cumulatively further the understanding of its etiology.
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