Pachymeningitis cervicalis hypertrophica.

Presented here is an autopsy case of pachymeningitis cervicalis hypertrophica. A 77-year-old female had the initial symptoms of cervical radiculopathy which terminated in the syndrome of spinal cord transection. Prior to the onset of radiculopathy, the patient had been admitted to the hospital because of a fever and had been shown to have granulomatous sinusitis. Autopsy revealed chronic granulomatous pachymeningitis of the cervical spinal cord, the lesion being mostly restricted to this region. From histopathologic similarities, the extension of sinusitis to cervical pachymeningitis was assumed, but this was not confirmed. An attempt to discover the causative micro-organisms was unsuccessful. The possibility of a limited form of Wegener's granulomatosis could be excluded in view of the absence of true angiitis. Corresponding to the levels of pachymeningitis, the spinal cord was also severely damaged, which was principally due to circulatory disturbance as a result of pachymeningitis.