Department of Neurology, King's College Hospital NHS Foundation Trust, London, UK
Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, UK.
Pract Neurol. 2023 Oct;23(5):441-445. doi: 10.1136/pn-2023-003750. Epub 2023 Jul 17.
Hypertrophic pachymeningitis is a rare disorder of the dura mater of the spine or brain. It can be caused by inflammatory, infective or neoplastic conditions or can be idiopathic. We report a man with hypertrophic pachymeningitis and bilateral chronic subdural haematoma caused by IgG4-related disease. We highlight the diagnostic challenges and discuss possible underlying mechanisms of subdural haematoma formation in inflammatory conditions. Isolated IgG4-related hypertrophic pachymeningitis with chronic subdural haematoma is very rare; previously reported cases have suggested a possible predilection for men in their sixth decade, presenting with headache as the dominant symptom. Given the rarity and complexity of the condition, it should be managed in a multidisciplinary team setting.
肥厚性硬脑膜炎是一种罕见的脊柱或脑硬脑膜疾病。它可由炎症、感染或肿瘤性疾病引起，也可自发性发生。我们报告了一例由 IgG4 相关疾病引起的肥厚性硬脑膜炎和双侧慢性硬脑膜下血肿的患者。我们强调了诊断方面的挑战，并讨论了炎症情况下硬脑膜下血肿形成的可能潜在机制。孤立性 IgG4 相关肥厚性硬脑膜炎伴慢性硬脑膜下血肿非常罕见；此前报道的病例提示可能偏爱 60 岁左右的男性，以头痛为主要症状。鉴于该疾病的罕见性和复杂性，应在多学科团队中进行管理。
