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Neurological Surgery No Shinkei Geka Volume 25, Issue 4 （April 1997）

Neurological Surgery 脳神経外科 25巻4号（1997年4月発行）

Japanese English

症例

Hypertrophic spinal pachymeningitisの1例 A case of hypertrophic spinal pachymeningitis 朝本俊司 ¹ , 杉山弘行 ¹ , 日野健 ¹ , 小粥正博 ¹ , 林宗貴 ¹ , 岩間淳一 ¹ , 土居浩 ¹ , 長尾毅彦 ² , 井田正博 ³ , 高橋学 ⁴ , 松本清 ⁵ Shunji ASAMOTO ¹ , Hiroyuki SUGIYAMA ¹ , Ken HINO ¹ , Masahiro OGAI ¹ , Munetaka HAYASHI ¹ , Junichi IWAMA ¹ , Hiroshi DOI ¹ , Takehiko NAGAO ² , Masahiro IDA ³ , Manabu TAKAHASHI ⁴ , Kiyoshi MATSUMOTO ⁵ ¹東京都立荏原病院脳神経外科 ²東京都立荏原病院神経内科 ³東京都立荏原病院放射線科 ⁴東京都立荏原病院病理検査科 ⁵昭和大学病院脳神経外科 ¹Department of Neurosurgery, Tokyo Metropolitan Ebara Hospital ²Department of Neurology, Tokyo Metropolitan Ebara Hospital ³Department of Radiology, Tokyo Metropolitan Ebara Hospital ⁴Department of Pathology, Tokyo Metropolitan Ebara Hospital キーワード： hypertrophic spinal pachymeningitis（HSP） , MRI Keyword: hypertrophic spinal pachymeningitis（HSP） , MRI pp.363-366

発行日 1997年4月10日 Published Date 1997/4/10

DOI https://doi.org/10.11477/mf.1436901378

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Abstract 文献概要
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I．はじめに

　Hypertrophic spinal pachymeningitis（以下HSP）は，1869年Charcotによって初めて記載された比較的稀な疾患で^4），臨床症状及び画像診断上，特異的所見が無いため術前診断に苦慮することが多い．今回われわれは，下位頸椎から上位胸椎にかけて限局性のHSPにより脊髄症状を呈した1例を経験したので，若干の文献的考察を加え報告する．

A 79-year-old woman was admitted to our hospital complaining of gait disturbance. At the time of admis-sion, she had incomplete monoparesis of the left lower extremity. with a sensory level of T6. MR images showed a thickened dura at the C6-T4 vertebral levels. The thickened dura showed low intensities on T1- and T2-weighted images, and was homogeneously enhanced by Gd-DTPA. Hypertrophic spinal pachy-meningitis (HSP) was suspected, and laminectomy was performed from T2 to T3. The thickened dura was found and partially resected. Microscopically, the dia-gnosis was HSP. Steroid therapy was initiated after surgery. Postoperatively, the patient's physical status and radiographic images improved. The etiology of HSP is not clear in most cases. It is difficult to dia-gnose radiographically, although MR imaging can help differentiate it from other disorders. T1- and T2-weighted images of HSP show low intensities, and the T1-weighted image is homogeneously enhanced by Gd-DTPA. Treatment is early decompressive surgery with possible excision of the involved dura. Steroid therapy was effective in our case.