Adhesive arachnoiditis is a rare yet serious complication that may arise following events such as subarachnoid hemorrhage (SAH), intraparenchymal hemorrhage, meningitis, trauma, or the surgical removal of a lesion [1], [2]. When this condition arises from a spontaneous subarachnoid hemorrhage (SAH), it is most commonly reported following the rupture of aneurysms in the vertebral and posterior inferior cerebellar arteries [3], [4]. Arachnoiditis can interfere with the flow of cerebrospinal fluid (CSF), potentially leading to issues like spinal arachnoid cysts, syringomyelia, and entrapment of the 4th ventricle [5], [6] (Fig. 1). These complications can cause a range of neurological symptoms, including headaches, paresis, gait disturbances, and sensory deficits, significantly impacting a patient's functional abilities. Treatment strategies for adhesion arachnoiditis vary greatly, ranging from lysis of adhesions to different types of shunt procedures. Due to the limited number of reports on adhesive arachnoiditis following SAH, there is a lack of comprehensive experience in managing patients with this condition.

The aim of our study is to provide insights that will help in identifying key factors to improve patient outcomes of adhesive arachnoiditis following the rupture of aneurysms in the vertebral and posterior inferior cerebellar arteries.