Chiasmal arachnoiditis as a manifestation of generalized arachnoiditis in systemic vascular disease. Clinico-pathological report of two cases.

THE "Syndrome de Balado" (Balado and Satanowsky, 1929), later known as chiasmal arachnoiditis (Ch.A.) has been reported by many authors (Cushing, 1930a, b; Heuer and Vail, 1931; Craig and Lille, 1931; Vincent, Puech, and David, 1931; David, Hartmann, and Hebert, 1936; Bollack, David, and Puech, 1937a; Hausman, 1937; Vail, 1938). Its aetiology and pathogenesis have, however, remained controversial, and there is no agreement whether it is a specific entity or the manifestation of a more generalized disease of the meninges. One reason for this appears to be the lack of histopathological examinations, since the disease is not usually fatal. Only five cases have been reported in the literature with pathological studies (Davis and Haven, 1931; Bollack, David, and Puech, 1937b). Two additional cases are described in this report with clinico-pathological evidence and an attempt has been made to elucidate the pathogenesis of the syndrome.