Les pachyméningites

Fain, Olivier; Mékinian, A.

doi:10.1016/j.revmed.2017.03.011

Cited by 9 publications

(10 citation statements)

References 66 publications

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“…Numerous pathological processes target the meninges, including neoplasms, infections, and autoimmunity 3 . The term leptomeningitis indicates that the pia mater and/or the arachnoid are affected, while pachymeningitis describes a disease of the dura 6 . Because the dura encases the proximal portion of cranial nerves, the cavernous sinus, and the optic nerve sheath, pachymeningitis may damage these structures 7 .…”

Section: Concept and Anatomymentioning

confidence: 99%

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A clinical approach to hypertrophic pachymeningitis

Abrantes

Moraes

Filho

et al. 2020

Arq. Neuro-Psiquiatr.

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Importance: Hypertrophic pachymeningitis (HP) is a non-usual manifestation of rheumatologic, infectious, and neoplastic diseases. Etiological diagnosis is a challenge, but when made promptly it creates a window of opportunity for treatment, with the possibility of a total reversal of symptoms. Observations: HP is an inflammatory process of the dura mater that can occur as a manifestation of sarcoidosis, granulomatosis with polyangiitis, and IgG4-related disease. The HP case evaluation is extensive and includes central nervous system imaging, cerebrospinal fluid analysis, serology, rheumatologic tests, and systemic survey for other manifestations sites. After systemic investigation, meningeal biopsy might be necessary. Etiology guides HP treatment, and autoimmune disorders are treated with corticosteroids alone or associated with an immunosuppressor. Conclusion: HP is a manifestation of several diseases, and a precise etiological diagnosis is crucial because of the difference among treatments. An extensive investigation of patients with HP helps early diagnosis and correct treatment.

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Section: Concept and Anatomymentioning

confidence: 99%

“…Syphilis may present with HP as a meningovascular form. Serologic evaluation is essential to rule out this type of syphilis 6 . Tuberculosis is also associated with leptomeningitis and HP, generally with cognitive behavioral disorders, and systemic symptoms 41 .…”

Section: Infectious Diseasesmentioning

confidence: 99%

A clinical approach to hypertrophic pachymeningitis

Abrantes

Moraes

Filho

et al. 2020

Arq. Neuro-Psiquiatr.

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“…El pronóstico depende del momento en el que se identifique y trate esta entidad. La PH puede generar perdida de la audición, cefalea de difícil control y parálisis de nervios craneales 7 . En muchas ocasiones el diagnóstico es tardío y previamente los pacientes han presentado múltiples terapias empíricas para el manejo de migraña y otalgia.…”

Section: Introductionunclassified

Paquimeningitis Hipertrófica en Vasculitis ANCA Positivo: Reporte de caso y revisión de la literatura

et al. 2023

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La paquimeningitis hipertrófica (PH), es una manifestación poco frecuente de la vasculitis asociada a anticuerpos anti-citoplasma de neutrófilo (ANCA). La literatura describe compromiso de sistema nervioso central (SNC) en 2-8% de los casos en pacientes con vasculitis pauciinmune. Se presenta el caso de un paciente con antecedente de vasculitis anti-mieloperoxidasa (MPO) con un mes de evolución de cefalea hemicraneana izquierda. La resonancia magnética cerebral contrastada evidencia marcado engrosamiento y realce meníngeo dural en el hemicráneo izquierdo, predominante en el tentorio y la fosa posterior. Se descartaron causas infecciosas por lo que se llegó a la conclusión de compromiso meníngeo asociado a vasculitis. Se inició manejo inmunosupresor con mejoría del cuadro clínico. La rápida identificación y manejo de esta entidad puede cambiar su pronóstico sombrío. Se realizó una revisión de la literatura para brindar una herramienta para la toma de decisiones para los médicos que se enfrentan a esta entidad.

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“…A biopsy of the dura mater helps confirm the diagnosis. Treatment of pachymeningitis is usually with corticosteroids and treatment of the underlying etiology [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Tuberculous Hypertrophic Pachymeningitis

Cordeiro¹,

Gupta²,

Kanwar

et al. 2021

Cureus

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Tuberculous pachymeningitis is a rare disease that should be suspected in patients with chronic headaches, focal neurological signs, and magnetic resonance imaging (MRI) findings of dural thickening. We report the case of a 62-year-old male who presented with chronic headaches for over a year, progressive right-sided vision and hearing loss for six months, and progressive dysphagia for a month. On investigation, MRI showed dural thickening, cerebrospinal fluid showed lymphocytic pleocytosis with high protein and normal glucose levels, and biopsy of the dural matter showed necrotizing granulomas with Langhans giant cells. The patient responded well to antitubercular treatment and steroids. Follow-up MRI 24 months later showed almost complete resolution of meningeal enhancement. Though tuberculosis is an uncommon cause of pachymeningitis, it should be considered, as it responds well to treatment.

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Les pachyméningites

Cited by 9 publications

References 66 publications

A clinical approach to hypertrophic pachymeningitis

A clinical approach to hypertrophic pachymeningitis

Paquimeningitis Hipertrófica en Vasculitis ANCA Positivo: Reporte de caso y revisión de la literatura

Tuberculous Hypertrophic Pachymeningitis

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