肥厚性硬脑膜炎的临床、影像学及病理学特征(附1例报告)

目的 探讨肥厚性硬脑膜炎患者的临床、影像学及病理学特征.方法 回顾性分析1例此病患者的临床资料.结果 本例患者临床表现为头痛、双眼视力下降、眼球运动障碍、面神经瘫痪及声音嘶哑等;头部MRI示硬脑膜异常强化灶,以大脑镰、小脑幕等处为主;硬脑膜病理检查可见有慢性炎症改变,有多量浆细胞浸润,纤维组织浸润、增生、玻璃样变性,肉芽肿形成.皮质类固醇激素治疗后疗效显著.结论 肥厚性硬脑膜炎以头痛和多脑神经受累为主要临床表现;MRI可见特征性的硬脑膜强化改变;病理学检查有硬脑膜慢性炎症改变,是确诊的主要依据.

Characteristic features of clinical manifestation, imaging and pathology of hypertrophic cranial pachymeningitis (report of 1 case)

Objective To determine the characteristic features of clinical manifestation, imaging and pathology in the patients with hypertrophic cranial pachymeningitis (HCP). Methods All clinical data of 1 patient with HCP were studied retrospectively. Results The patient presented with heavy headache, progressive visual acuity decreased and hoarse voice. Brain MRI displayed abnormal strengthening signals in cerebral dura mater, especially in cerebral falx and tentorium of cerebellum. Pathological examination demonstrated chronic inflammation changes including numerous plasmocytes infiltration, accrementition and glassy degeneration of fibrous tissue, formation of granulation tissue. Therapy with corticosteroid hormone showed good effect for this patient.Conclusions HCP mainly presents with headache and paralysis of multiple cranial nerves. Distinctive sign on brain MRI is strengthening signal in cerebral dura. Chronic inflammation is the pathological change of this disease and pathological examination plays important role in diagnosis of HCP.