Srpski arhiv za celokupno lekarstvo 2013 Volume 141, Issue 3-4, Pages: 219-222
https://doi.org/10.2298/SARH1304219K
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Superficial siderosis: Case report and literature review
Kresojević Nikola D. (Klinički centar Srbije, Klinika za neurologiju, Beograd)
Petrović Igor N. (Klinički centar Srbije, Klinika za neurologiju, Beograd)
DragaševićMišković Nataša T. (Klinički centar Srbije, Klinika za neurologiju, Beograd)
Kostić Vladimir S. (Klinički centar Srbije, Klinika za neurologiju, Beograd)
Introduction. Superficial siderosis (SS) is caused by chronic subarachnoid
bleeding and is characterized by free iron and hemosiderin deposition along
the pial and subpial structures of central nervous system. SS leads to
progressive and irreversible CNS damage. The most common causes of chronic
subarachnoidal bleeding are tumors, head and spinal cord trauma,
arteriovenous malformations and aneurysms. SS is characterized by clinical
triad: sensorineural hearing loss, cerebellar ataxia and piramydal signs.
Brain MR imaging is the investigation of choice for the diagnosis of SS.
Typical findings include hypointensities seen on T2weighted MR imaging
around the brain, cerebellum, brain stem, spinal cord, VIII cranial nerve and
atrophy of cerebellum and medulla. Case Outline. A 71-yearold female patient
noticed hand tremor in the middle of the third decade of life, and later
slowly progressive bilateral hearing loss. At the age of 64 she developed un
steady gate, hand clumsiness and dysarthria, to became incapable of
independent walking and standing five years later. Clinical course and brain
MRI findings were typical for SS, but additional investigation did not reveal
the couse of subarahnoidal bleeding. Conclusion. SS represents a rare and
underrecognized condition that must be considered in all patients with
cerebellar syndrome of unknown cause. Early diagnosis of SS in some cases
with identified cause of chronic bleeding allowes therapeutic interventions
that may prevent further progression of the disease.
Keywords: superficial siderosis, subarachnoid hemorrhage, cerebellar ataxia
Projekat Ministarstva
nauke Republike Srbije, br. 175090