Masson C, Henin D, Decroix J P, Martin N, Cambier J, Masson M
Service de Neurologie, Hôpital Beaujon, Clichy.
Rev Neurol (Paris). 1989;145(1):16-23.
The clinical picture in three cases of chronic cranial pachymeningitis of unknown origin was dominated by headache, disturbed balance, a confusional state and cranial nerve lesions. The erythrocyte sedimentation rate was increased and the CSF showed inflammatory changes. CT scan imaging showed thickening of the tentorium cerebelli, which took up contrast intensely. Meningeal biopsy showed the dura-mater to be the site of a non-specific inflammatory process. No precise cause was found. Clinical manifestations in these three patients were remarkably corticosensitive but lesions did not regress on CT. The development of a state of corticodependence led to an attempt at treatment with radiotherapy and/or azathioprine, but follow up is insufficient to evaluate results.
三例不明原因的慢性颅骨硬脑膜炎患者的临床表现以头痛、平衡失调、意识模糊状态及颅神经损害为主。血沉加快，脑脊液显示有炎症改变。CT扫描成像显示小脑幕增厚，强化明显。硬脑膜活检显示硬脑膜为非特异性炎症过程的部位。未发现确切病因。这三名患者的临床表现对皮质激素高度敏感，但CT上病变未消退。皮质激素依赖状态的出现促使尝试采用放疗和/或硫唑嘌呤进行治疗，但随访时间不足，无法评估疗效。
