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논문 기본 정보

자료유형
학술저널
저자정보
Jee, Tae Keun (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) Lee, Sun-Ho (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) Kim, Eun-Sang (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) Eoh, Whan (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제56권 제2호
발행연도
2014.1
수록면
162 - 165 (4page)

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Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a chronic, progressive, inflammatory disorder characterized by marked fibrosis of the spinal dura mater with unknown etiology. According to the location of the lesion, it might induce neurologic deficits by compression of spinal cord and nerve root. A 58-year old female with a 3-year history of progressive weakness in both lower extremities was referred to our institute. Spinal computed tomography (CT) scan showed an osteolytic lesion involving base of the C6 spinous process with adjacent epidural mass. Magnetic resonance imaging (MRI) revealed an epidural mass involving dorsal aspect of cervical spinal canal from C5 to C7 level, with low signal intensity on T1 and T2 weighted images and non-enhancement on T1 weighted-enhanced images. We decided to undertake surgical exploration. At the operation field, there was yellow colored, thickened fibrous tissue over the dura mater. The lesion was removed totally, and decompression of spinal cord was achieved. Symptoms improved partially after the operation. Histopathologically, fibrotic pachymeninges with scanty inflammatory cells was revealed, which was compatible with diagnosis of idiopathic hypertrophic pachymeningitis. Six months after operation, motor power grade of both lower extremities was normal on physical examination. However, the patient still complained of mild weakness in the right lower extremity. Although the nature of IHSP is generally indolent, decompressive surgery should be considered for the patient with definite or progressive neurologic symptoms in order to prevent further deterioration. In addition, IHSP can present as an osteolytic lesion. Differential diagnosis with neoplastic disease, including giant cell tumor, is important.
#Idiopathic hypertrophic spinal pachymeningitis #Osteolytic lesion #Mimicking giant cell tumor #Decompressive surgery #Differential diagnosis

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참고문헌 (29)

참고문헌 신청
Adler JR / 1991 / Pachymeningitis associated with a pulmonary nodule / Neurosurgery 29:283~287 google schola Agdal N / 1980 / Pachymeningitis cervicalis hypertrophica syphilitica / Acta Derm Venereol 60:184~186 google schola Astrom KE / 1963 / Extensive intracranial lesions in a case of orbital non-specific granuloma combined with polyarteritis nodosa / J Clin Pathol 16:137~143 google schola Bucy PC / 1952 / Hypertrophic spinal pachymeningitis with special reference to appropriate surgical treatment / J Neurosurg 9:564~578 google schola Dumont AS / 2000 / Idiopathic hypertrophic pachymeningitis : a report of two patients and review of the literature / Can J Neurol Sci 27:333~340 google schola

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