Intraventricular cytarabine in a case of idiopathic hypertrophic pachymeningitis.
Idiopathic hypertrophic chronic pachymeningitis (IHCP) is characterised by inflammatory fibrotic thickening of the dura mater. Long term management is controversial. A 28 year old man with craniospinal IHCP and prominent lymphocytic meningitis is reported. Cerebrospinal fluid and histological examination suggested a CD4+ T cell driven process and B cell stimulation. After surgical, tuberculostatic, and immunosuppressive treatment failed to control the progressive meningeal hypertrophy, causing severe headache and neurological disability, the disease process eventually abated with intraventricular cytarabine treatment.
University of Regensburg, Department of Neurology, Universitätsstrasse 84, 93042 Regensburg, Germany. ingo.kleiter@klinik.uni-regensburg.de
I
I
Kleiter
V H
VH
Hans
G
G
Schuierer
J
J
Marienhagen
P
P
Hau
H
H
Schütz
U
U
Bogdahn
A
A
Steinbrecher
D000328:Adult; D002908:Chronic Disease; D003561:Cytarabine / Q000008:administration & dosage / Q000627:therapeutic use*; D018450:Disease Progression; D004388:Dura Mater / Q000473:pathology; D006261:Headache / Q000209:etiology; D006801:Humans; D006984:Hypertrophy; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007249:Inflammation; D007276:Injections, Intraventricular; D008297:Male; D008581:Meningitis / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D003561:Cytarabine