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Published on: May 19, 2020

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Cranio cervical tuberculous hypertrophic pachymeningitis

Satya Bhusan Senapati1, Sudhansu Sekhar Mishra1, Srikanta Das1

  • 1Department of Neurosurgery, SCB Medical College and Hospital, Cuttack, Odisha, India.

Surgical Neurology International
|May 13, 2014
PubMed
Abstract

Insights

Tuberculous hypertrophic pachymeningitis, a rare cause of cervical spinal cord compression, can mimic idiopathic conditions. Early diagnosis and antitubercular treatment are crucial for recovery, avoiding corticosteroid-induced exacerbation.

Area of Science:

  • Neurology
  • Infectious Diseases

Background:

  • Hypertrophic pachymeningitis involves dural fibrosis and thickening, leading to neurological deficits.
  • It can be idiopathic or secondary to inflammatory/infectious causes.
  • Tuberculous hypertrophic pachymeningitis in the cranio-cervical region is infrequently documented.

Observation:

  • A 50-year-old female presented with progressive quadriparesis, neck stiffness, and dysphagia.
  • Her condition worsened after corticosteroid administration.
  • Examination revealed high cervical compressive myelo-radiculopathy and lower cranial nerve palsy.

Findings:

  • Diagnosis was confirmed via serum analysis, CSF studies, and MRI.
  • The patient showed improvement with antitubercular treatment.
  • Multilevel cervical compressive myelo-radiculopathy with lower cranial nerve involvement was observed.

Implications:

  • Consider hypertrophic pachymeningitis in multilevel cervical compressive myelo-radiculopathy with lower cranial involvement.
  • Exclude infectious etiologies before diagnosing idiopathic hypertrophic pachymeningitis.
  • Corticosteroid use can exacerbate the disease if an infectious cause is present.
Keywords:
Cranio cervicalhypertrophic pachymeningitistuberculous

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