2例肥厚性硬脑膜炎的临床和磁共振影像学特征  

Characteristics of the Clinical Manifestations and MRI of Hypertrophic Cranial Pachymeningitis

作　　者：吐尔逊[1] 杨新玲[1] 张小宁[1] 马建华[1] 贾文霄[2] 杨利霞[2] 王俭[2] 

机构地区：[1]新疆医科大学第一附属医院神经内科,830054 [2]新疆医科大学第一附属医院磁共振室,830054

出　　处：《中国临床神经科学》2006年第2期193-196,共4页Chinese Journal of Clinical Neurosciences

摘　　要：目的:报道2例肥厚性硬脑膜炎(HCP),探讨其临床和磁共振(MRI)成像特征。方法:分析2例患者临床和MRI特点,结合文献讨论HCP的病因、临床表现和影像学特点等。结果:HCP病因多样。临床以头痛和多组脑神经损害为主。1例低颅压性头痛为HCP罕见症状。MRI增强扫描以颅内硬脑膜弥漫性异常增厚为特点。结论:HCP是以头痛和硬脑膜弥漫性增厚为特点。根据临床缓慢局灶和全脑功能障碍症状,结合增强MRI特点,有利于早期作出较明确的诊断。Aim： Hypertrophic cranial pachymeningitis （HCP） is a rare condition prone to be misdiagnosed. Two typical cases of HCP were reported. The characteristics of the clinical picture and MRI of HCP were reviewed from references, aiming to intensify the clinical understanding about HCP. Methods： The characteristics of the clinical symptoms and MRI of the two cases with HCP were reviewed and analyzed. Literatures concerned with the clinical symptoms and MRI findings, the causes, diagnosis and differential diagnosis and the treatment options of HCP were reviewed. Results： HCP is a rare disease of central nervous system characterized by diffuse intracranial pachymeningeal thickening by non-specific inflammatory process. The causes can be both idiopathic and secondary type. Major clinical symptoms are severe headache, peripheral cranial nerve palsies （Ⅵ,Ⅶ, Ⅴ,Ⅷ,Ⅻ） and so on. One case was presented with intracranial hypotension, being a rare phenomenon, causing severe headache. MRI scan revealed diffusely thickened dura mater with obvious enhancement as a band in the cerebral apex and tentorium of cerebellum. The diagnosis of HCD should be differentiated from other chronic meningitis. The patients were cured by etiological treatment, glucocorticoids and antibiotics. Conclusion： HPC is characterized by diffusely thickened dura mater with various causes. Enhanced MRI scan is an essential method for early diagnosis of HCP in patients presenting with focal or diffuse cerebral dysfunction.

关 键 词：肥厚性硬脑膜类 临床特征 磁共振成像 

分 类 号：Q813[生物学—生物工程] Q189