SUPERFICIAL SIDEROSIS OF THE CENTRAL-NERVOUS-SYSTEM AFTER BRACHIAL-PLEXUS INJURY

Superficial siderosis is a rare condition characterized by deposition of hemosiderin in the leptomeninges and in the subpial layers of the b rain and spinal cord. It is associated with cerebrospinal fluid abnorm alities consistent with recurrent bleeding into the subarachnoid space . The usual symptoms are hearing loss, ataxia, spastic paraparesis, se nsory and sphincter deficits, and mental deterioration. A case is pres ented of severe superficial siderosis of the central nervous system in a 51-year-old man who had suffered a brachial plexus injury at the ag e of 20 years. The diagnosis was made by means of magnetic resonance i maging 16 years after the initial symptoms, which comprised bilateral hearing loss and anosmia. Subarachnoid bleeding was due to traumatic p seudomeningocele of the brachial plexus, a very unusual cause of super ficial siderosis. This case is interesting insofar as the surgical tre atment prevented further bleeding and possibly progression of the dise ase.