title: Idiopathic hypertrophic spinal pachymeningitis: a case report.
abstract: A 67-year-old man presented with progressive quadriplegia. Magnetic resonance imaging (MRI) revealed spinal cord compression by a thickened dura ventral to the cord from C3 to C7. The lesion was isointense on both T1- and T2-weighted images, and showed contrast enhancement on T1-weighted gadorinium-enhanced images. A diagnosis of idiopathic hypertrophic spinal pachymeningitis was confirmed histologically after anterior decompression and fusion. Only partial excision was achieved. Marked improvement of the quadriplegia was attained only after steroid therapy. At the 3-month follow-up, the patient was able to walk with a cane. The affected site showed no remission on MRI despite continuous steroid therapy. At the 2-year follow-up, the patient could walk independently.
authors.affiliation: Department of Orthopaedic Surgery, Toho University School of Medicine, Ota-ku, Tokyo, Japan. drkan@med.toho-u.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
authors.forename: Akihito
authors.initials: A
authors.lastname: Wada
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Maki
authors.initials: M
authors.lastname: Ishii
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Shibuya
authors.forename: Toru
authors.initials: T
authors.lastname: Suguro
mesh_terms: D000368:Aged; D002574:Cervical Vertebrae; D006801:Humans; D008297:Male; D008581:Meningitis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy