Hypertrophic Spinal Pachymeningitis

Mikawa, Yoshihiro; Watanabe, Ryoji; Hino, Yousuke; Hirano, Kouji

doi:10.1097/00007632-199403000-00021

Cited by 48 publications

(44 citation statements)

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“…Involvement of the meninges can be diffuse or focal and both cranial and spinal meninges can be affected 3 . Some diseases selectively involve the dura mater whereas others affect predominantly the leptomeninges.…”

Section: Discussionmentioning

confidence: 99%

Hypertrophic pachymeningitis: case report

Deus-Silva

Queiróz

Zanardi

et al. 2003

Arq. Neuro-Psiquiatr.

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-Hypertrophic pachymeningits is an unusual cause of neurological symptoms and is often secondary to infections, carcinomatosis or inflammatory diseases. It may also be idiopathic. We report a case of pachymeningitis which was manifested primarily by psychosis and visual loss with optic atrophy and destruction of nasal septum. The patient, a 45 year old woman was submitted to extensive investigation without evidence of any underlying disease. A meningeal biopsy was performed and showed a mostly unspecific inflammatory process with extensive fibrosis of the dura and few early stage granulomas. These findings suggest either neurosarcoidosis or idiopathic hypertrophic pachymeningitis.KEY WORDS: hypertrophic pachymeningits, neurosarcoidosis, psychosis, optic neuropathy. P P P P Paquimeningite hipertrófica: relato de caso aquimeningite hipertrófica: relato de caso aquimeningite hipertrófica: relato de caso aquimeningite hipertrófica: relato de caso aquimeningite hipertrófica: relato de caso RESUMO -Paquimeningite hipertrófica é uma causa incomum de sintomas neurológicos, sendo frequentemente secundária a infecções, carcinomatose ou doenças inflamatórias. Pode também ser idiopática. Relatamos um caso de paquimeningite que se manifestou inicialmente por psicose e diminuição da acuidade visual com atrofia óptica e destruição do septo nasal. A paciente, de 45 anos de idade, foi submetida a extensa investigação, não sendo evidenciada nenhuma doença de base. Foi realizada biopsia de meninge, a qual evidenciou um processo inflamatório com intensa fibrose e raros granulomas em estágio inicial. Esses achados sugerem neurossarcoidose ou paquimeningite hipertrófica idiopática.PALAVRAS-CHAVE: paquimeningite hipertrófica, neurossarcoidose, psicose, neuropatia óptica.

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Section: Discussionmentioning

confidence: 99%

Hypertrophic pachymeningitis: case report

Deus-Silva

Queiróz

Zanardi

et al. 2003

Arq. Neuro-Psiquiatr.

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“…Spinal hypertrophic pachymeningitis is rare. The cervical and thoracic regions are probably most affected, and the meningeal thickening causes radiculomyelopathy (17).…”

Section: Discussionmentioning

confidence: 99%

“…Histopathological examination of thickened dura shows non-specific inflammatory reaction in various phases of evolution, with fibroblastic infiltration of neutrophils, lymphocytes and plasma cells (4,16). Vasculitis and granulomatous changes have been described (17,21).…”

Section: Case Reportmentioning

confidence: 99%

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En mann i 40-årene med hodepine og tåkesyn

Bjørke¹,

Wahl²,

Kalstad³

2012

Tidsskriftet

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Headache with increased cell number in the spinal fluid, fever and meningeal thickening immediately gives rise to associations with bacterial meningitis. When there is sub-acute onset of symptoms and an atypical course of disease with poor response to antibiotics, however, differential diagnostic possibilities should be considered. The patient is man in his 40s with severe complications of a rare meningeal condition.

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“…Scale bar 100 lm has increased. Patients display a wide age range, from 15 to 77 years (median 46.0 years) [17]. Males are affected more frequently than females (3:2).…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome of idiopathic hypertrophic thoracic pachymeningitis

et al. 2011

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Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a comparatively rare disease characterized by hypertrophic inflammation of the dura mater and clinical symptoms that progress from local pain to myelopathy. We report a case of IHSP followed up for 20 years in a 46-year-old man. Expansive laminoplasty was performed in 1991, and this case has been previously reported by a co-author. After 17 years, the patient's gait disturbance returned. Physical examination and imaging confirmed IHSP that had developed into syringomyelia at the T2-L1 conus level. This case was diagnosed as adhesive spinal arachnoiditis due to pachymeningitis caused by syringomyelia. T1-T4 laminectomy, a syringo-subarachnoid shunt (S-S shunt), and L2-L3 laminectomy were performed. The patient again developed dysesthesia and gait disturbance 3 years after the second operation. Most reports of IHSP have limited their focus to short-term follow-up after initial treatment with no long-term results. At present, there are only five reports referring to long-term results of greater than 5 years. All but one case needed additional surgery. To the best of our knowledge, this is the first case in which syringomyelia occurred in a patient with IHSP. It is important to note that syringomyelia may be a cause of symptom recrudescence during long-term follow-up in IHSP patients.

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Hypertrophic Spinal Pachymeningitis

Cited by 48 publications

References 0 publications

Hypertrophic pachymeningitis: case report

Hypertrophic pachymeningitis: case report

En mann i 40-årene med hodepine og tåkesyn

Long-term outcome of idiopathic hypertrophic thoracic pachymeningitis

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