Brainstem and Spinal Arachnoiditis Ossificans Associated With Neurocysticercosis: A Case Report

Arachnoiditis ossificans (AO), a very rare entity that can cause severe neurological deficit, is associated with an inflammatory response and compressive effect on the spinal cord. A 65-year-old woman with diagnosis of arachnoiditis ossificans, who had a past medical history of neurocysticercosis diagnosed eight years before the actual onset that was accompanied by obstructive hydrocephalus and required bilateral ventriculoperitoneal shunts, presented with lower limb paresis. The spinal CT reported large calcified subdural spinal plaques. She was treated with high-dose steroids with subsequent improvement of the clinical manifestations. Spinal neurocysticercosis is a rare manifestation of this disease, although the Mexican population is especially prone to it, due to the endemic presence of this entity, it can provoke spinal arachnoiditis. We conclude that the chronic inflammation of the spinal meninges induced by the cysticercosis could encourage the arachnoid cells to go through osteoblastic metaplasia with consequent production of thick calcium deposits, such as those found in AO. Thus it may be associated with AO. We present, to our knowledge, the first patient with AO-associated neurocysticercosis.