A case of idiopathic hypertrophic cranial pachymeningitis presenting as chronic subdural hematoma

VernacularTitle:以慢性硬脑膜下血肿为发病表现的特发性肥厚性硬脑膜炎一例
Author: Zhan HE ¹ ; Fang DING ; Jiandong RONG ; Yongli GAN
Author Information

1. 宁波市医疗中心李惠利医院神经外科
Keywords: Dura mater; Meningitis/pathology; Meningitis/diagnosis; Magnetic resonance imaging; Case reports
From: Journal of Zhejiang University. Medical sciences 2016;45(5):539-542
CountryChina
Language:Chinese
Abstract: A 26-year-old male presented with a 6-day history of paroxysmal headache which was worsen with nausea and vomiting for 1 day.Head CT on admission revealed left chronic subdural hematoma with midline shift .An emergency Burr hole drainage for hematoma was performed .Headache recurred 6 days later .MRI of the brain revealed a diffuse thickening and a gadolinium-enhancement of the falx , cranial dura mater and tentorium cerebelli on the left side with pia mater involved .Lumber puncture showed increased intracranial pressure and elevated IgG level in cerebrospinal fluid.Histological examination of the biopsy specimen showed thickened , fibrotic dura with a sterile chronic inflammation .According to pathological examination , idiopathic hypertrophic cranial pachymeningitis was considered as the final diagnosis .Symptoms were improved with steroid pulse therapy .