Central nervous system superficial siderosis: A case report and literature review

中枢神经系统浅表铁沉积症:病例报告及文献综述

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Abstract

RATIONALE: Superficial siderosis of the central nervous system (SSCNS) is a rare condition characterized by iron deposition on the surface tissues of the central nervous system. However, the diagnosis and treatment of diseases lack uniform principles. PATIENT CONCERNS: A 64-year-old woman who was admitted to our hospital with progressive difficulty walking. DIAGNOSES: Based on the patient's history of traumatic lumbar fractures, progressive hearing loss, and physical examination findings indicative of cerebellar ataxia, sensorineural deafness, and bilateral pyramidal tract involvement, combined with susceptibility-weighted imaging revealing linear low-signal intensities on the surfaces of the cerebral hemispheres, sulci, and spinal cord, a diagnosis of SSCNS was made. INTERVENTIONS: The patient received treatment with Ginkgo biloba leaf extract tablets, mecobalamin, and vitamin B1. OUTCOMES: Her symptoms remained stable. LESSONS: A literature review has revealed that most patients with SSCNS exhibit diverse clinical manifestations. Clinicians should consider SSCNS in patients presenting with hearing impairment and gait ataxia, particularly those receiving anticoagulant therapy, brain injury, or surgical intervention. The clinical manifestations, imaging findings, management strategies, and prognosis of these cases are discussed, highlighting the key roles of magnetic resonance imaging and susceptibility-weighted imaging in establishing a definitive diagnosis. In addition, the importance of a multidisciplinary team approach in providing holistic care for individuals has been emphasized. Clinicians are advised to investigate SSCNS in patients with hearing impairment and gait ataxia, particularly in those with a history of brain injury or surgery, using magnetic resonance imaging results.

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