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Idiopathic hypertrophic spinal pachymeningitis: report of two cases with typical MR imaging findings

S Pai1, C T Welsh, S Patel

  • 1Department of Neurosurgery, Medical University of South Carolina, Charleston, SC 29425, USA.

AJNR. American Journal of Neuroradiology
|March 14, 2007
PubMed
Abstract

Insights

Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a rare condition causing chronic myelopathy. Surgical treatment was successful for two patients diagnosed with IHSP via histology, highlighting key MRI findings.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Chronic progressive myelopathy presents diagnostic challenges.
  • Idiopathic hypertrophic spinal pachymeningitis (IHSP) is an uncommon cause of spinal cord compression.
  • Histopathological confirmation is crucial for diagnosing spinal pathologies.

Observation:

  • Two patients presented with progressive myelopathy.
  • Magnetic Resonance (MR) imaging revealed an extramedullary mass compressing the spinal cord.
  • The mass exhibited characteristic low T2 signal intensity with peripheral contrast enhancement.

Findings:

  • Surgical intervention was successfully performed in both cases.
  • Histological examination confirmed the diagnosis of idiopathic hypertrophic spinal pachymeningitis (IHSP).
  • The characteristic MR imaging findings are indicative of IHSP.

Implications:

  • The study identifies specific MR imaging features suggestive of IHSP.
  • Early recognition of these imaging patterns can aid in timely diagnosis and treatment.
  • This contributes to understanding and managing rare causes of myelopathy.

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