Case Series
 
Superficial siderosis following trauma to the cervical spine: Case series and review of literature
Pranab Sinha1, Sophie Jane Camp2, Harith Akram3, Robin Bhatia4, Adrian Thomas Carlos Hickman Casey5
1MRCS, BSc, MBBS, Flat 1, 28-32 London Rd, Tunbridge Wells, Kent, TN1 1BX.
2PhD, MRCS, MBBS, MA (Oxon), the National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.
3FRCS (Neuro.Surg), MB ChB, the National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.
4FRCS (SN), PhD, MA, MBBS, the National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.
5FRCS, FRCS SW, MBBS, the National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.

Article ID: Z01201703CS10082PS
doi:10.5348/ijcri-201703-CS-10082

Address correspondence to:
Sinha Pranab
MRCS, BSc, MBBS, MRCS, BSc, MBBS
Flat 1, 28-32 London Rd, Tunbridge Wells
Kent, TN1 1BX

Access full text article on other devices

  Access PDF of article on other devices

[HTML Full Text]   [PDF Full Text] [Print This Article]
[Similar article in Pumed] [Similar article in Google Scholar]


How to cite this article
Sinha P, Camp SJ, Akram H, Bhatia R, Casey ATCH. Superficial siderosis following trauma to the cervical spine: Case series and review of literature. Int J Case Rep Images 2017;8(1):11–16.


Abstract
Superficial siderosis is a rare progressive disease associated with chronic hemosiderin deposition on the surfaces of the central nervous system (CNS). It typically manifests clinically in sensorineural hearing loss, cerebellar ataxia, and pyramidal signs. Recurrent or continuous bleeding into the cerebrospinal fluid is implicated in the disease process. The magnetic resonance imaging gradient-echo T2-weighted images have high sensitivity for hemosiderin deposits that bathe the CNS, giving the characteristic black rimmed area of hypointensity apparent on these images. The natural history and its treatments are still not clearly defined in literature. Our report details the clinical course and management of three cases of superficial siderosis following either cervical spine or brachial plexus injury. All of them underwent surgical intervention. In two of the cases, positive cessation of the intradural bleeding was achieved through surgery but clinical and radiological improvement occurred in only one of the cases. One patient had a negative intradural exploration. To date, 30 cases of superficial siderosis reported in the literature have undergone surgical intervention. Cessation of disease progression or neurological improvement has been documented in 18 of these cases. Our cases reveal that patients with superficial siderosis often develop severe functional impairment due to the progressive nature of the disease. On balance, we are of the opinion that early craniospinal imaging and surgical exploration should be undertaken, at least to attempt to halt neurological deterioration.

Keywords: Cervical Spine, Review, Superficial Siderosis, Trauma


[HTML Full Text]   [PDF Full Text]

Author Contributions:
Pranab Sinha – Substantial contributions to concept and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the paper to be published
Sophie Jane Camp – Substantial contributions to concept and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the paper to be published
Harith Akram – Substantial contributions to concept and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the paper to be published
Robin Bhatia – Substantial contributions to concept and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the paper to be published
Adrian Thomas Carlos Hickman Casey – Substantial contributions to concept and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the paper to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Pranab Sinha et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.