Related Experiment Video
Updated: Jun 13, 2026
03:47
A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients
Published on: October 25, 2024
Idiopathic hypertrophic spinal pachymeningitis: a case report
Hiroshi Takahashi1, Akihito Wada, Yuichiro Yokoyama
1Department of Orthopaedic Surgery, Toho University School of Medicine, Ota-ku, Tokyo, Japan. drkan@med.toho-u.ac.jp
Journal of Orthopaedic Surgery (Hong Kong)
|April 30, 2010
Summary
Idiopathic hypertrophic spinal pachymeningitis caused severe quadriplegia. Steroid therapy led to significant recovery, enabling independent walking despite persistent MRI findings.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a rare condition causing spinal cord compression.
- Diagnosis often requires a combination of imaging and histological confirmation.
Observation:
- A 67-year-old male presented with progressive quadriplegia due to C3-C7 spinal cord compression.
- MRI revealed a thickened dura with characteristic signal intensities and contrast enhancement.
- Surgical decompression provided only partial relief.
Findings:
- Histological confirmation of IHSP post-decompression.
- Significant neurological improvement occurred following steroid administration.
- MRI showed no remission of the pachymeningeal thickening despite clinical recovery and ongoing steroid treatment.
Implications:
- Steroid therapy can be highly effective in managing IHSP symptoms, even when imaging does not show resolution.
- This case highlights the importance of clinical response in guiding treatment for IHSP.
- Long-term steroid use may be necessary for sustained functional recovery in IHSP patients.
Related Concept Videos
01:22Bacterial Meningitis I: Introduction
Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
01:18Viral Meningitis
Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
01:26Brain Abscess l: Introduction
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
01:26Bacterial Meningitis II: Pathophysiology
Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
01:24Bacterial Meningitis
Bacterial meningitis is a severe infectious disease involving inflammation of the meninges, the protective membranes surrounding the brain and spinal cord. It occurs when pathogenic bacteria cross the blood–brain barrier and enter the cerebrospinal fluid. Common causative organisms include Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, Listeria monocytogenes, and Escherichia coli K1. The exact route of entry varies by pathogen and host condition.Routes of Entry...
01:19Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...