Luo Zhong, Cao Piao, Xu Jing-Qing, Yan Rong, Wang Jian, Liang Tao, Chen Ya, Xu Zu-Cai
Department of Neurology Affiliated Hospital of Zunyi Medical University Zunyi China.
Department of Neurology, Guizhou Aerospace Hospital Zunyi China.
Ibrain. 2023 Apr 2;11(1):112-116. doi: 10.1002/ibra.12099. eCollection 2025 Spring.
A 57-year-old man who suffered from a headache for 1 year, accompanied by blurred vision for 7 months and numbness in his left face for 1 week was admitted to the Affiliated Hospital of Zunyi Medical University on May 7, 2022. One year ago, the patient had no obvious precipitating factor of paroxysmal stabbing pain in the whole skull with dizziness, which could be relieved by oneself after lasting for 1-2 min each time, with about 20 episodes per day. The cranial magnetic resonance imaging revealed changes in bilateral frontal lobe ischemic foci, bilateral frontal, ethmoid, sphenoid and maxillary sinusitis, and retinal macular degeneration. After hormone shock treatment, the condition improved. He suffered from headaches again with blurred vision in the right eye 7 months ago and was initially diagnosed with multiple sclerosis. He then was discharged after improvement due to hormone shock therapy. Oral hormone therapy was continued outside the hospital, but he stopped it due to drug side effects (details remained unclear). After cutting off, he developed a headache and visited our hospital once more, the relevant tests were performed and the patient was diagnosed with idiopathic hypertrophic pachymeningitis (IHP). The symptoms were slightly abated after hormone therapy. We hope that through this case report, we can deepen the clinicians' understanding of IHP, and improve the diagnosis rate of the disease through relevant examinations in future clinical work, so that patients can receive timely treatment and the mental pressure and economic burden caused by the disease on patients are reduced.
一名57岁男性，头痛1年，伴视力模糊7个月，左侧面部麻木1周，于2022年5月7日入住遵义医科大学附属医院。1年前，患者无明显诱因出现全颅骨阵发性刺痛伴头晕，每次持续1 - 2分钟后可自行缓解，每日发作约20次。头颅磁共振成像显示双侧额叶缺血灶、双侧额窦、筛窦、蝶窦及上颌窦炎，以及视网膜黄斑变性。经激素冲击治疗后病情好转。7个月前患者再次出现头痛伴右眼视力模糊，初诊为多发性硬化症。经激素冲击治疗病情好转后出院。出院后继续口服激素治疗，但因药物副作用（具体情况不详）停药。停药后患者再次出现头痛，遂来我院就诊，完善相关检查后诊断为特发性肥厚性硬脑膜炎（IHP）。经激素治疗后症状稍有缓解。我们希望通过本病例报告，加深临床医生对IHP的认识，并在今后的临床工作中通过相关检查提高该病的诊断率，使患者能够得到及时治疗，减轻疾病给患者带来的精神压力和经济负担。
