Cervicothoracic arachnoiditis—a rare complication of aneurysmal intracranial subarachnoid haemorrhage

Introduction Subarachnoid haemorrhage is a catastrophic condition which has significant morbidity and mortality, with mortality rate ranging between 8–67% and is associated with significant morbidity among the survivors. Arachnoiditis of the spinal cord is a very rare complication which can occur months to years after the subarachnoid haemorrhage. Case presentation We report a case of cervicothoracic arachnoiditis following the subarachnoid haemorrhage secondary to posterior inferior cerebellar artery (PICA) aneurysm with posterior fossa AVM (arterio-venous malformation) causing dense paraplegia. Discussion The haemorrhage that occurs into the fourth ventricle passes to the subarachnoid space via foramen of Magendie and Luschka. This subsequently induces inflammatory changes of the meninges predisposing to arachnoiditis. Early recognition and intervention may prevent this devastating complication or at least reduce the morbidity.