Key findings from the article
•The paper describes a 55-year-old man with classical iSS (blood-siderosis pattern in infratentorial regions) who had a longstanding history of hearing loss and gait ataxia.
•Imaging and CSF analysis in this case revealed:
•MRI showed siderosis (iron/haemosiderin deposition) in the cerebellum, brainstem etc.
•There was a ventral epidural cerebrospinal fluid (CSF) collection fronting the spinal cord, and a dural defect at T9-10 identified via a “reverse dynamic CT myelography” technique.
•After surgical repair of the dural defect (closing the leak), follow-up lumbar puncture showed dramatic reduction in CSF ferritin (from 413 ng/mL to 18 ng/mL) and RBCs went from >4,000 to <1.
•At 18-month follow-up, the patient’s neurological symptoms had not progressed further.
•The authors emphasise: classical iSS is caused by persistent bleeding into the subarachnoid space (via a dural defect/CSF leak) which deposits iron (haemosiderin) on brain/nerve surfaces.
•They point out that early detection of the dural defect and timely surgical repair may stop further progression of neurological damage.
•They also note that evidence for other treatments (iron-chelation, medical therapies) is limited; surgery to stop the bleed is the strongest intervention.
6 months without treatment and ticking.
#Sweden #InfratentorialSuperficialSiderosis #APSAwareness #CSFleak
link.springer.com/article/10…