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Arachnoid web presenting with acute myelopathy after minor trauma and subtle imaging findings: illustrative case

Shinichiro Tsukamoto1,2, Gaku Hidaka1, Masashi Uchida1

  • 1Department of Neurosurgery, St. Marianna University School of Medicine, Kawasaki.

Journal of Neurosurgery. Case Lessons
|January 22, 2026
PubMed
Abstract

Insights

Arachnoid webs (AW) can cause spinal cord compression after trauma, even with subtle imaging. Prompt surgical removal of the arachnoid web can lead to significant recovery of motor function.

Area of Science:

  • Neurosurgery
  • Spinal Surgery
  • Neurology

Background:

  • Arachnoid web (AW) is a rare cause of spinal cord compression.
  • Diagnosis can be challenging due to subtle imaging findings.

Purpose of the Study:

  • To highlight the diagnostic challenges and successful surgical management of arachnoid webs presenting after trauma.

Main Methods:

  • Case report of a 29-year-old male with paraparesis post-trauma.
  • Diagnostic imaging revealed subtle spinal cord deviation.
  • Surgical exploration and resection of the arachnoid web.

Main Results:

  • Surgical resection of the arachnoid web restored spinal cord pulsation.
  • The patient experienced significant improvement in motor function postoperatively.
  • Histopathology confirmed the diagnosis of arachnoid web.

Conclusions:

  • Arachnoid webs should be considered in trauma-related myelopathy, even with subtle imaging.
  • Timely surgical intervention is crucial for functional recovery.
Keywords:
arachnoid webmicrosurgical resectionminor traumamyelopathyspinal cord compressionthoracic spine

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