肥厚性硬脑膜炎的临床、病理和影像学特点(附1例报告)  

Characteristic features of clinical manifestation,imaging and pathology of hypertrophic cranial pachymeningitis(report of 1 case)

作　　者：陈卓友[1] 钱传忠[1] 张志翔[1] 高萍[1] 恽文伟[1] 

机构地区：[1]南京医科大学附属常州第二人民医院神经内科,江苏常州213003

出　　处：《中风与神经疾病杂志》2011年第6期532-534,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：目的研究肥厚性硬脑膜炎(hypertrophic cranial pachymeningitis,HCP)的临床表现、病理和MRI特征。方法对1例HCP患者的临床、病理和MRI检查资料进行回顾性分析并总结其特点。结果 HCP多慢性起病,临床以头痛和多颅神经麻痹为主要表现。MRI可见受累硬脑膜T1相呈等或略低信号,T2相呈高信号,增强扫描后增厚的硬脑膜明显均匀强化,硬脑膜病理检查可见纤维组织内炎症细胞浸润。激素治疗有效,MRI复查硬脑膜变薄,累及范围缩小,强化减轻。结论 HCP以头痛、多脑神经受累为主要临床表现。MRI扫描可见特征性的硬脑膜强化改变。病理学检查是确诊依据。Objective To study characteristic features of clinical manifestation,imaging and pathology of hypertrophic cranial pachymeningitis（HCP）.Methods The clinical findings,pathology and MRI appearances of 1 patients with HCP were analyzed retrospectively.Results The onset of the disease was mostly chronic.The main clinical features were headache and cranial nerve palsy.The MRI could find thickened dura mater.The signal intensity was changed with similar gray matter or less in T1-weighted imaging（T1WI）and hyperintensity signal in T2-weighted imaging（T2WI）.The thickened dura mater was markedly enhanced when using contrast media.Pathological examination demonstrated chronic inflammation changes in fibrous tissue.Therapy with corticosteroid hormone showed good effect for this patient.MRI also found the abnormal signaI intensity of the brain tissue decreased significantly.Conclusions HCP mainly presents with chronic headache and paralysis of multiple cranial nerves,and have distinctive signs of thickened dura mater on MRI,Combined with pathology results,it can be correctly diagnosed.

关 键 词：肥厚性硬脑膜炎 临床 病理 影像 

分 类 号：R742[医药卫生—神经病学与精神病学]