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Cranio cervical tuberculous hypertrophic pachymeningitis

BACKGROUND: Hypertrophic pachymeningitis is a unique clinical entity characterized by fibrosis and thickening of dura mater resulting in neurological dysfunction. It could be idiopathic or due to variety of inflammatory and infectious conditions. Tuberculous hypertrophic pachymeningitis involving cr...

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Autores principales: Senapati, Satya Bhusan, Mishra, Sudhansu Sekhar, Das, Srikanta, Parida, Deepak Kumar, Satapathy, Mani Charan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014816/
https://www.ncbi.nlm.nih.gov/pubmed/24818059
http://dx.doi.org/10.4103/2152-7806.130907
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author Senapati, Satya Bhusan
Mishra, Sudhansu Sekhar
Das, Srikanta
Parida, Deepak Kumar
Satapathy, Mani Charan
author_facet Senapati, Satya Bhusan
Mishra, Sudhansu Sekhar
Das, Srikanta
Parida, Deepak Kumar
Satapathy, Mani Charan
author_sort Senapati, Satya Bhusan
collection PubMed
description BACKGROUND: Hypertrophic pachymeningitis is a unique clinical entity characterized by fibrosis and thickening of dura mater resulting in neurological dysfunction. It could be idiopathic or due to variety of inflammatory and infectious conditions. Tuberculous hypertrophic pachymeningitis involving cranio cervical region is rarely reported. CASE DESCRIPTION: A 50-year-old female presented with history of progressive quadriparesis and stiffness of neck for 2 years, dysphagia to liquid for past 3 months. Her condition rapidly deteriorated when another physician prescribed her corticosteroid. Physical examination revealed high cervical compressive myelo-radiculopathy with lower cranial nerve palsy and neck rigidity. Series of serum analysis, cerebrospinal fluid (CSF) study and contrast magnetic resonance imaging (MRI) clinched the diagnosis. She improved on antitubercular treatment. CONCLUSION: In case of multilevel cervical compressive myelo-radiculopathy with lower cranial involvement, possibility of hypertrophic pachymeningitis should be kept in mind. Before diagnosing it as idiopathic, infectious causes should be excluded otherwise prescription of corticosteroid will flare up the disease process.
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spelling pubmed-40148162014-05-09 Cranio cervical tuberculous hypertrophic pachymeningitis Senapati, Satya Bhusan Mishra, Sudhansu Sekhar Das, Srikanta Parida, Deepak Kumar Satapathy, Mani Charan Surg Neurol Int Case Report BACKGROUND: Hypertrophic pachymeningitis is a unique clinical entity characterized by fibrosis and thickening of dura mater resulting in neurological dysfunction. It could be idiopathic or due to variety of inflammatory and infectious conditions. Tuberculous hypertrophic pachymeningitis involving cranio cervical region is rarely reported. CASE DESCRIPTION: A 50-year-old female presented with history of progressive quadriparesis and stiffness of neck for 2 years, dysphagia to liquid for past 3 months. Her condition rapidly deteriorated when another physician prescribed her corticosteroid. Physical examination revealed high cervical compressive myelo-radiculopathy with lower cranial nerve palsy and neck rigidity. Series of serum analysis, cerebrospinal fluid (CSF) study and contrast magnetic resonance imaging (MRI) clinched the diagnosis. She improved on antitubercular treatment. CONCLUSION: In case of multilevel cervical compressive myelo-radiculopathy with lower cranial involvement, possibility of hypertrophic pachymeningitis should be kept in mind. Before diagnosing it as idiopathic, infectious causes should be excluded otherwise prescription of corticosteroid will flare up the disease process. Medknow Publications & Media Pvt Ltd 2014-04-16 /pmc/articles/PMC4014816/ /pubmed/24818059 http://dx.doi.org/10.4103/2152-7806.130907 Text en Copyright: © 2014 Senapati SB. http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Case Report
Senapati, Satya Bhusan
Mishra, Sudhansu Sekhar
Das, Srikanta
Parida, Deepak Kumar
Satapathy, Mani Charan
Cranio cervical tuberculous hypertrophic pachymeningitis
title Cranio cervical tuberculous hypertrophic pachymeningitis
title_full Cranio cervical tuberculous hypertrophic pachymeningitis
title_fullStr Cranio cervical tuberculous hypertrophic pachymeningitis
title_full_unstemmed Cranio cervical tuberculous hypertrophic pachymeningitis
title_short Cranio cervical tuberculous hypertrophic pachymeningitis
title_sort cranio cervical tuberculous hypertrophic pachymeningitis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014816/
https://www.ncbi.nlm.nih.gov/pubmed/24818059
http://dx.doi.org/10.4103/2152-7806.130907
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