Journal of Korean Neurosurgical Society

  • 제48권2호
  • /
  • Pages.181-184
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  • 2010
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Idiopathic Hypertrophic Cranial Pachymeningitis Misdiagnosed as Acute Subtentorial Hematoma

  • Park, Ik-Seong (Department of Neurosurgery, St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Hoon (Department of Neurosurgery, St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Chung, Eun-Yong (Department of Anethesiology and Pain Medicine, St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Cho, Kwang-Wook (Department of Neurosurgery, St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • 투고 : 2010.01.22
  • 심사 : 2010.08.03
  • 발행 : 2010.08.28
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초록

A case of idiopathic hypertrophic cranial pachymeningitis (IHCP) misdiagnosed as an acute subdural hematoma is reported. A 37-year-old male patient presented with headache following head trauma 2 weeks earlier. Computerized tomography showed a diffuse high-density lesion along the left tentorium and falx cerebri. Initial chest X-rays revealed a small mass in the right upper lobe with right lower pleural thickening, which suggested lung cancer, such as an adenoma or mediastinal metastasis. During conservative treatment under the diagnosis of a subdural hematoma, left cranial nerve palsies were developed (3rd and 6th), followed by scleritis and uveitis involving both eyes. Magnetic resonance imaging (MRI) revealed an unusual tentorium-falx enhancement on gadolinium-enhanced T1-weighted images. Non-specific chronic inflammation of the pachymeninges was noticed on histopathologic examination following an open biopsy. Systemic steroid treatment was initiated, resulting in dramatic improvement of symptoms. A follow-up brain MRI showed total resolution of the lesion 2 months after steroid treatment. IHCP should be included in the differential diagnosis of subtentorial-enhancing lesions.

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참고문헌

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피인용 문헌

  1. Idiopathic Hypertrophic Cranial Pachymeningitis Associated With Intermediate Uveitis vol.35, pp.2, 2010, https://doi.org/10.3109/01658107.2011.559683
  2. Hypertrophic Cranial Pachymeningitis and Skull Base Osteomyelitis by Pseudomonas Aeruginosa: Case Report and Review of the Literature vol.4, pp.2, 2010, https://doi.org/10.4021/jocmr777w
  3. IgG4-Related Intracranial Hypertrophic Pachymeningitis : A Case Report and Review of the Literature vol.55, pp.5, 2010, https://doi.org/10.3340/jkns.2014.55.5.300
  4. Hypertrophic pachymeningitis vol.31, pp.7, 2010, https://doi.org/10.1007/s00381-015-2680-z
  5. A Case of Idiopathic Hypertrophic Pachymeningitis in the Clival Region presenting with Hypoglossal Nerve Palsy vol.28, pp.10, 2010, https://doi.org/10.7887/jcns.28.640