• Steven Knafo, Anne Herbrecht, Cécile Cauquil, Mariana Sarov, Adeline Not, Claire Ancelet, Ghaida Nasser, Dan Benhamou, Pierre-Antoine Oillic, Stéphanie Guey, Timothée Lenglet, Fabrice Parker, and Nozar Aghakhani.
• Department of Neurosurgery, Bicêtre Hospital, AP-HP, Le Kremlin-Bicêtre, France.
• Neurosurgery. 2024 Feb 15.

Background And ObjectivesCerebrospinal fluid (CSF) collections extending longitudinally at the anterior aspect of the spinal dura have been reported in association with various conditions and under multiple names. The aim of this study was to report cases associated with brachial amyotrophy (BA) and examine its relationship with other clinical variants.MethodsWe conducted a retrospective cohort study including patients who presented with a motor deficit of the upper limbs and an anterior interdural CSF collection on spinal MRI. We performed a systematic review of the literature to include cases revealed by BA.ResultsSeven patients presenting with BA and a confirmed dural dissection on spinal MRI were included. All patients were male with a slowly progressing history of asymmetrical and proximal motor deficit of the upper limbs. Chronic denervation affecting mostly C5 and C6 roots was found on electroneuromyography. Spinal MRI demonstrated an anterior CSF collection dissecting the interdural space and exerting a traction on cervical motor roots. Dynamic computed tomography myelogram localized the dural defect every time it was performed (4/7 cases), and surgical closure was possible for 3 patients, leading to resolution of the collection. Literature review yielded 18 other published cases of spinal dural dissections revealed by BA, including 4 in association with spontaneous intracranial hypotension and 4 others in association with superficial siderosis.ConclusionWe propose a unifying diagnosis termed "spinal anterior dural dissection" (SADD) to encompass spinal dural CSF collections revealed by BA (SADD-BA), spontaneous intracranial hypotension (SADD-SIH), or superficial siderosis (SADD-SS).Copyright © Congress of Neurological Surgeons 2024. All rights reserved.

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