Superficial siderosis

Case contributed by Yu-Ming Tang

Presentation

Ataxia. Limb weakness.

Patient Data

Age: 64
Gender: Male
mri

Mild hypointensity along the pial surface of the brainstem and cerebellar folio.

Focal volume loss and hyperintensity in the right frontal lobe.

Superior vermian atrophy.

mri

Extensive anterior subdural collection in the cervico-thoracic spine.

Previous anterior fusion at C3-5 and L4-S1.

Case Discussion

Superficial siderosis (SS), with evidence of prior trauma and spinal surgery.  No other obvious source of recurrent hemorrhage was identified.

Cerebellar atrophy is often present in SS, especially at the superior vermis, presumably due to where preferential hemosiderin deposition.

An extensive longitudinal extra-arachnoid intraspinal fluid filled collection is frequently seen in patients with idiopathic SS. In this case, this may be associated with a dural defect at the level of the cervical fusion.

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