| Idiopathic hypertrophic spinal pachymeningitis : report of two cases and review of the literature. | |
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MedLine Citation:
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PMID: 22200026 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a rare inflammatory disease characterized by hypertrophic inflammation of the dura mater and various clinical courses that are from myelopathy. Although many associated diseases have been suggested, the etiology of IHSP is not well understood. The ideal treatment is controversial. In the first case, a 55-year-old woman presented back pain, progressive paraparesis, both leg numbness, and voiding difficulty. Initial magnetic resonance imaging (MRI) demonstrated an anterior epidural mass lesion involving from C6 to mid-thoracic spine area with low signal intensity on T1 and T2 weighted images. We performed decompressive laminectomy and lesional biopsy. After operation, she was subsequently treated with steroid and could walk unaided. In the second case, a 45-year-old woman presented with fever and quadriplegia after a spine fusion operation due to lumbar spinal stenosis and degenerative herniated lumbar disc. Initial MRI showed anterior and posterior epidural mass lesion from foramen magnum to C4 level. She underwent decompressive laminectomy and durotomy followed by steroid therapy. However, her conditions deteriorated gradually and medical complications occurred. In our cases, etiology was not found despite through investigations. Initial MRI showed dural thickening with mixed signal intensity on T1- and T2-weighted images. Pathologic examination revealed chronic nonspecific inflammation in both patients. Although one patient developed several complications, the other showed slow improvement of neurological symptoms with decompressive surgery and steroid therapy. In case of chronic compressive myelopathy due to the dural hypertrophic change, decompressive surgery such as laminectomy or laminoplasty may be helpful as well as postoperative steroid therapy. |
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Authors:
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Jee Hee Kim; Young Mok Park; Dong Kyu Chin |
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Publication Detail:
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Type: Journal Article Date: 2011-10-31 |
Journal Detail:
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Title: Journal of Korean Neurosurgical Society Volume: 50 ISSN: 1598-7876 ISO Abbreviation: J Korean Neurosurg Soc Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-12-26 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101467054 Medline TA: J Korean Neurosurg Soc Country: Korea (South) |
Other Details:
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Languages: eng Pagination: 392-5 Citation Subset: - |
Affiliation:
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Department of Neurosurgery, Gangnam Severance Spine Hospital, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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