Hypertrophic pachymeningitis as a result of a retropharyngeal inflammatory pseudotumor: Case report

Kenichi Matsumoto, Yoshihiro Natori, Eiko Hirokawa, Toru Iwaki, Bernard George, Griffith R. Harsh IV, Jack P. Rock, Andrew H. Kaye

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

OBJECTIVE AND IMPORTANCE: An extremely rare case of a patient with hypertrophic pachymeningitis that resulted from an inflammatory pseudotumor of retropharynx is described. CLINICAL PRESENTATION: A 59-year-old man with a 9-year history of retropharyngeal inflammatory pseudotumor sought care for severe headache and multiple cranial nerve palsies. Magnetic resonance imaging and computed tomographic scans revealed pachymeningeal enhancement and obstructive hydrocephalus attributable to marked dural thickening around the foramen magnum. INTERVENTION: Decompression of the foramen magnum, C1 laminectomy, and meningeal biopsy were performed. The histological examination of the biopsy specimen revealed chronic inflammatory infiltrate in the hypertrophic dura mater. Corticosteroid pulse therapy was subsequently completed. Clinical and neuroradiological findings improved remarkably. CONCLUSION: A new case of hypertrophic pachymeningitis as a result of a retropharyngeal inflammatory pseudotumor is presented. We review and discuss the clinical features and the pathogenic mechanisms of hypertrophic pachymeningitis.

Original languageEnglish (US)
Pages (from-to)1061-1065
Number of pages5
JournalNeurosurgery
Volume51
Issue number4
DOIs
StatePublished - Oct 1 2002
Externally publishedYes

Keywords

  • Inflammatory pseudotumor
  • Magnetic resonance imaging
  • Meningeal enhancement
  • Pachymeningitis

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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