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Intraventricular cytarabine in a case of idiopathic hypertrophic pachymeningitis
I Kleiter1, V H Hans, G Schuierer
1University of Regensburg, Department of Neurology, Universitätsstrasse 84, 93042 Regensburg, Germany. ingo.kleiter@klinik.uni-regensburg.de
Abstract:
Idiopathic hypertrophic chronic pachymeningitis (IHCP) is characterised by inflammatory fibrotic thickening of the dura mater. Long term management is controversial. A 28 year old man with craniospinal IHCP and prominent lymphocytic meningitis is reported. Cerebrospinal fluid and histological examination suggested a CD4+ T cell driven process and B cell stimulation. After surgical, tuberculostatic, and immunosuppressive treatment failed to control the progressive meningeal hypertrophy, causing severe headache and neurological disability, the disease process eventually abated with intraventricular cytarabine treatment.
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