Fain O, Mekinian A
Service de médecine interne, hôpital Saint-Antoine, AP-HP, DHUi2B, université Paris 6, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
Service de médecine interne, hôpital Saint-Antoine, AP-HP, DHUi2B, université Paris 6, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
Rev Med Interne. 2017 Sep;38(9):585-591. doi: 10.1016/j.revmed.2017.03.011. Epub 2017 Apr 14.
Pachymeningitis is a fibrosing and inflammatory process, which involves the dura mater. Some pachymeningitis are cranial and induce headaches and cranial nerve palsies. Others are spinal and responsible for nerve roots or spinal cord compression. MRI shows contrast enhancement thickening of the dura mater. Etiologies are infectious (syphilis, tuberculosis, etc.) or inflammatory (sarcoidosis, granulomatosis with polyangiitis, IgG4-related disease, idiopathic). Corticosteroids are the main treatment. The use of immunosuppressive drugs or rituximab is yet to be determined and probably adapted to each etiology.
硬脑膜炎是一种纤维化和炎症性过程，累及硬脑膜。一些硬脑膜炎为颅内性，可引起头痛和颅神经麻痹。另一些为脊柱性，可导致神经根或脊髓受压。磁共振成像（MRI）显示硬脑膜强化增厚。病因包括感染性（梅毒、结核等）或炎症性（结节病、肉芽肿性多血管炎、IgG4相关性疾病、特发性）。皮质类固醇是主要治疗方法。免疫抑制药物或利妥昔单抗的使用尚未确定，可能需根据每种病因进行调整。
