Superficial siderosis

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

This patient has been on a long-term follow-up at this hospital due a traumatic cervical pseudomeningocoele. He has cerebellar dysfunction with difficulties to walk. Deafness.

Patient Data

Age: 46
Gender: Male

MRI Brain

mri

Extensive hemosiderin deposition coating the brain stem, cerebellar folia and basal cisterns is again identified with associated atrophy which, although stable compared to the last study from last year, it has demonstrated progression since the images from 10 years ago.

The cerebral parenchyma and supratentorial ventricles are unremarkable. No extra-axial collections or mass is evident.

Conclusion: Extensive superficial siderosis in the posterior fossa and base of the brain remains stable. Comparison with previous studies from last year has shown progressive cerebellar and brainstem atrophy along this period.

MRI Cervical spine

mri

Status post prior laminectomies C6 - T1.

The large pseudomeningocoele on the left posterolateral aspect extending between C6 and T1 remains stable compared to the previous exam (last year). It abuts the cord which is distroted and demonstrates increased T2 signal and myelomalacia in this region. The cord is thinned in its cervicothoracic transition.

Superficial siderosis is again noted lining the cervical cord circumferentially.

Multilevel degenerative disc disease is evident and remains unchanged

Conclusion: The C6 to T1 pseudomeningocoele, the adjacent spinal cord atrophy and the extensive superficial siderosis remain stable.      

Case Discussion

This case illustrates the presence of superficial siderosis involving the posterior fossa and cervical spine as a consequence of previous hemorrhages, which have caused hemosiderin deposition on cord, nerve surfaces and cerebellum.

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