Superficial Siderosis

 Synonyms:

Central nervous system siderosis:

Diagnosis:

MRI:

  • T2: dark outlining similar to GRE of all affected structures
  • T2 gradient echo GRE: dark outlining to cerebellum, cerebellar folia, VIII cranial nerve & meninges & rest of the brain or spinal cord
  • FLAIR: dark outlining similar to GRE of all affected structures
  • T1: high signal on CNS surfaces
  • T1+C: no enhancement of brain surfaces
  • May show source of bleeding

CSF:

  • High protein
  • Xanthochromia

Clinical features:

  • Bilateral sensorineural hearing loss & ataxia

 

Pathology:

  • Thickened brown stained meninges
  • Hemosiderin laden macrophages near the surface
  • Loss of cerebellar Purkinje cells, gliosis

Treatment:

  • Treat source of bleeding

Related articles: