Presentation
No description of findings present after expansive laminoplasty for hypertrophic spinal pachymeningitis has been reported. [ncbi.nlm.nih.gov]
Depending upon the level involved and degree of spinal canal stenosis, the patient may present with single or multi-level radiculopathy and myelopathy. Our patients also presented with radiculopathy and myelopathic symptoms. [annalsofian.org]
Entire Body System
- Constitutional Symptom
She had no constitutional symptoms. Past history was not contributory. The examination showed left side C-5,6,7 and right sided C-5,6 muscle weakness. The supinator and biceps jerks were decreased. [japi.org]
There were no constitutional symptoms. She had three episodes of diplopias, headaches and fever in the past 9 months followed by spontaneous recovery after the first two episodes. She had bilateral VI nerve palsy. [annalsofian.org]
- Malaise
General malaise is frequently the only symptom during the e:':l.rl y period of sup~uration within the cranium and, in the nresence of mastoid involvement, must be c?-(refully considered. [docplayer.net]
Cardiovascular
- Heart Disease
The reasons leading to dural hemorrhage,- a head injury, sometimes very small, high blood pressure, atherosclerosis age and is caused by chronic infections, decompensated heart disease, blood diseases (malignant anemia, leukemia), bloody diates, chronic [medicalency.com]
He denied any history of hypertension, diabetes, heart diseases, infectious diseases, or trauma as well as any history of direct contact with cattle or sheep or tuberculosis. [frontiersin.org]
Eyes
- Lacrimation
This disease can involve virtually any organ, and pancreas, salivary glands, and lacrimal glands are most commonly affected. [frontiersin.org]
Neurologic
- Cranial Nerve Involvement
Cranial nerve VIII is the most commonly involved cranial nerve, followed by CN V, VII, IX, X, and XII, with equal frequency [ 4 ]. [omicsonline.org]
involvement and helped us to arrive at a plausible diagnosis explaining the noncontiguous cranial nerve involvement and excluded diabetic neuropathy. [jcor.in]
Lower cranial nerves were chiefly involved in two patients whereas optic nerve was the predominantly affected nerve in one. [neurologyindia.com]
Besides, cranial nerve palsy was another common symptom in HP, particularly of the optic nerve, auditory nerve, and abductor nerve in this study, which were associated with involvement of the dura surrounding the intracranial optic nerve and the cavernous [hindawi.com]
nerve palsies with decreased sensation in the right V cranial nerve distribution. [annalsofian.org]
- Babinski Sign
A neurological examination revealed severe quadriplegia and bilateral positive Babinski signs, numbness and hypoaesthesia below the C5 level. His manual muscle test scores below the level of the deltoid were [yumpu.com]
Babinski sign, and Chaddock sign) remained positive. [frontiersin.org]
A patchy hyperesthesia to pinprick was noted diffusely without evidence of a sensory level, the patient was diffusely hyperreflexic with bilateral Babinski signs. Bilateral Hoffmann signs of the upper extremities were present. [ajns.paans.org]
Deep tendon reflexes were present and symmetric, and Babinski sign was flexor on both sides. What are the differential diagnoses? Back pain is one of the leading reasons for medical visits. [jpgmonline.com]
- Papilledema
Clinical features include headache, cranial nerve impairment, paraparesis or tetraparesis, ataxia, hydrocephalus, papilledema, hemorrhage or secondary vascular occlusions (5). [path.upmc.edu]
Her left optic disk was atrophic and there was papilledema on the right eye. Another MRI was performed and showed the same pattern of meningeal enhancement seen on the first one. [scielo.br]
Other neurologic symptoms of IHP include cranial nerve palsies (cranial nerves IV–VIII), cerebellar ataxia, seizures, and neuroophthalmic symptoms such as visual field loss, complete blindness, optic neuropathy, and increased intracranial pressure with papilledema [pubs.rsna.org]
- Neuralgia
Idiopathic hypertrophic pachymeningitis presenting with occipital neuralgia. Afr Health Sci 2015 15:302-306. PMID: 25834565. 3. Bosman T, Simonin C, Launay D, Caron S, DestĂŠe A, Defebvre L. [e-neurospine.org]
[…] loss. ( 26238133 ) Lok J.Y....Young A.L. 2015 17 Clinico-radiological spectrum and outcome in idiopathic hypertrophic pachymeningitis. ( 25703277 ) Dash G.K....Radhakrishnan A. 2015 18 Idiopathic hypertrophic pachymeningitis presenting with occipital neuralgia [malacards.org]
Other symptoms include hypoacusia, tinnitus, dizziness, trigeminal neuralgia, and dysphagia. Eventually the clinical picture will be that of Tolosa-Hunt or Garcin syndrome5. [scielo.br]
- Unable to Walk
ABSTRACT We report a case of idiopathic hypertrophic spinal pachymeningitis in a 56-year-old woman who complained of a tingling sensation and progressive weakenss of both legs since 6 months prior, and then was unable to walk for 1 week. [jpatholtm.org]
On presentation, he was unable to walk. He had a history of hypertension, diabetes mellitus, and hyperlipidaemia. [yumpu.com]
One day prior to admission, he was unable to walk or urinate. He denied any history of hypertension, diabetes, heart diseases, infectious diseases, or trauma as well as any history of direct contact with cattle or sheep or tuberculosis. [frontiersin.org]
Workup
Diagnosing the primary cause is crucial for optimal management, which usually requires extensive clinical and laboratory workup. [annalsofian.org]
Case details (continued) The further workup revealed a HIV virus load of 198,322 and CD4 count of 281 cells/μL (normal range: 490-1740 cells/μL). Tuberculin skin test reading was positive 8 mm. [jpgmonline.com]
[…] fibrosis. [14] Chronic periaortitis had been recognized as a common manifestation of IgG4RD, and it commonly affects abdominal aorta; it often coexists with autoimmune pancreatitis, another prototype manifestation of this disease. [15] In the diagnostic workup [indianjrheumatol.com]
Other Pathologies
- Lymphocytic Infiltrate
It is defined as a systemic disease characterized histopathologically by extensive IgG4-positive plasma cell infiltration of various organs together with T-lymphocyte infiltration.1 Pancreas is the most frequently affected organ. [n.neurology.org]
Surg Neurol Int 5:52. doi:10.4103/2152-7806.130907 Article PubMed Central PubMed Google Scholar Nakamura T, Hirakawa K, Higashi S, Tomoda K, Tsukano M, Iyama K, Sakae T (2007) CD8+ T lymphocytes infiltrate predominantly in the inflammatory foci of MPO-ANCA-positive [link.springer.com]
Pathologic examination of the dura revealed dense collagen bundles with lymphocyte and histiocyte infiltration. There was no evidence of tumor, granuloma, acid fast organisms or fungi. (See fig. 4) Cultures of the excised dura were negative. [ajns.paans.org]
Nakamura T, Hirakawa K, Higashi S, Tomoda K, Tsukano M, Iyama K, Sakae T (2007) CD8+ T lymphocytes infiltrate predominantly in the inflammatory foci of MPO-ANCA-positive thoracic hypertrophic pachymeningitis in a patient with HLA-A24. [springermedizin.de]
Treatment
Spinal canal decompression and autogenous bone grafting are accepted treatments in the young patient. Careful observation of the patient to watch for local progression is necessary. [ncbi.nlm.nih.gov]
Early identification and treatment of underlying diseases like vasculitis, IgG4, Behcets and malignancies might improve treatment outcomes and prevent systemic complications. [annalsofian.org]
Recent decades have also witnessed fundamental progress in understanding of the pathophysiology of spinal cord diseases, treatment options, neurosurgical procedures, and endovascular treatments. [books.google.com]
Prognosis
The prognosis of idiopathic HSP with positive inflammatory signs may be worse; the authors stress the significance of early surgical treatment. [ncbi.nlm.nih.gov]
According to a review of the English and Japanese literature on idiopathic HSP, the prognosis of patients with positive inflammatory signs is worse than that of those with no inflammatory signs. [scienceopen.com]
Etiology
On the basis of the etiology, pachymeningitis can be idiopathic or secondary, associated with various other etiologies like infection, inflammation, granulomatous or neoplastic disorders. [annalsofian.org]
An unusual etiology of spinal cord compression by thickened dura mater was found with a contrast ring- or crescent-shaped enhancement on gadopentetate magnetic resonance imaging. [ncbi.nlm.nih.gov]
Although many associated diseases have been suggested, the etiology of IHSP is not well understood. The ideal treatment is controversial. [londonspine.com]
Syphilis and tuberculosis have been considered the chief etiological agents in this disease, the former being by far... Bibliography HASSIN GB: Circumscribed suppurative (non-tuberculous) peripachymeningitis. Histopathologic study of a case, Arch. [acpjournals.org]
Epidemiology
In epidemiology, it may be used to analyze a closely grouped series of events or cases of disease or other health-related phenomenon with well-defined distribution patterns in relation to time or place or both. [bioportfolio.com]
The epidemiology and pathogenesis of IgG4-RHP are poorly un-derstood. [docslide.com.br]
Epidemiology Pachymeningitis is most often found in infants and in middle-aged men. [iliveok.com]
However, until now, no large-scale epidemiological data have been made available worldwide. IgG4-related diseases usually affect elderly patients (>50 years), with a significant male predominance (11, 15). [frontiersin.org]
Epidemiology of sarcoidosis in the Isle of Man: evidence for space time clustering. Thorax 1987;42:427-430. [ Links ] 27. Kern DG, Neil MA, Wrenn DS, Varone JC. Investigation of an unique time-space cluster of sarcoidosis in firefighters. [scielo.br]
Pathophysiology
Springer Science & Business Media, 06.12.2012 - 246 Seiten Because of the topographic and pathophysiologic information obtained with contemporary neuroimaging techniques, CT and MR scanning now constitute the most important investigation in clinical neurology [books.google.de]
Recent decades have also witnessed fundamental progress in understanding of the pathophysiology of spinal cord diseases, treatment options, neurosurgical procedures, and endovascular treatments. [books.google.com]
Abstract In pathophysiology and clinical practice, the intracranial pressure (ICP) profiles in the supratentorial and infratentorial compartments are unclear. [ncbi.nlm.nih.gov]
Prevention
Idiopathic HSP is a clinical emergency and early surgical intervention is essential to prevent irreversible damage to the nervous system. [Indexed for MEDLINE] Free full text [ncbi.nlm.nih.gov]
Idiopathic HSP is a clinical emergency and early surgical intervention is essential to prevent irreversible damage to the nervous system. [jstage.jst.go.jp]
Early identification and treatment of underlying diseases like vasculitis, IgG4, Behcets and malignancies might improve treatment outcomes and prevent systemic complications. [annalsofian.org]