Ishii A, Hayashi A, Ohkoshi N, Matsuno S, Hoshino S, Tamaoka A, Shoji S
Department of Neurology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
No To Shinkei. 1998 Jun;50(6):579-83.
A case of hypertrophic cranial pachymeningitis associated with intramedullary lesion was reported. A 57-year-old male presented with the symptoms of Jacksonian seizure and weakness of right lower extremity. Neurological examination showed weakness and muscular atrophy of right lower extremity (MMT 1-2) and hyperreflexia. Superficial sensation and position sense were normal, however cortical sensory disturbance was recognized in his right lower extremity. MRI revealed diffuse dural thickening with gadolinium enhancement in the left convexity and hyperintense lesion in the bilateral (left dominant) frontal to parietal lobe on T2 weighted image. Magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) showed occlusion of the superior sagittal sinus. Histological examination revealed extensive fibrous tissue with lymphocytes infiltration around the vessels. The cause of the intramedullary lesion in this patient may have been related to the occlusion of superior sagittal sinus, due to thickening dura mater and influence of inflammation.
报告了一例与髓内病变相关的肥厚性颅骨硬脑膜炎病例。一名57岁男性出现杰克逊癫痫发作症状和右下肢无力。神经系统检查显示右下肢无力和肌肉萎缩（MMT 1-2级）以及反射亢进。浅感觉和位置觉正常，但右下肢存在皮质感觉障碍。MRI显示左侧凸面硬脑膜弥漫性增厚并伴有钆增强，在T2加权图像上双侧（以左侧为主）额叶至顶叶有高信号病变。磁共振血管造影（MRA）和数字减影血管造影（DSA）显示上矢状窦闭塞。组织学检查显示血管周围有广泛的纤维组织伴淋巴细胞浸润。该患者髓内病变的原因可能与上矢状窦闭塞有关，这是由于硬脑膜增厚和炎症影响所致。
