肥厚性硬脑膜炎5例报道及文献复习

钱伟东; 陈守康; 屈洪党

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肥厚性硬脑膜炎5例报道及文献复习

钱伟东 , 陈守康 , 屈洪党

文章导航 > 蚌埠医学院学报 > 2010, 35 > 6: (564-567)

引用本文:

Citation:

肥厚性硬脑膜炎5例报道及文献复习

1. 蚌埠医学院第一附属医院神经内科, 安徽蚌埠 233004;
2. 蚌埠医学院第一附属医院放射科, 安徽蚌埠 233004

作者简介: 钱伟东(1967-),女,副主任医师,副教授.

中图分类号: R515.2

Hypertrophic cranial pachymeningitis:a report of 5 cases and review of the literature

1. Department of Neurology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China;
2. Department of Radiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China
CLC number: R515.2

摘要: 目的:探讨肥厚性硬脑膜炎(hypertrophic cranial pachymeningitis,HCP)的临床、病理和影像学特点。方法:对5例HCP患者的临床资料结合文献进行回顾性分析。结果:5例患者均表现为头痛,其中2例伴言语障碍;1例伴肢体抽搐,反应迟钝,颅神经受损,行走不稳;1例伴记忆障碍。MRI平扫2例显示脑实质内有水肿改变,增强后5例硬脑膜广泛强化,尤其是额、顶部硬脑膜、大脑镰及小脑幕强化明显。1例行硬脑膜组织活检发现硬脑膜明显增厚,病理示硬脑膜纤维增生,大量浆细胞、淋巴细胞、巨噬细胞、嗜中性粒细胞浸润,灶性钙化,考虑为慢性非特异性炎;"硬膜下方"脑组织血管扩张,浆细胞、巨噬细胞为主的炎细胞浸润,相应部位脑实质也为非特异性炎性改变。结论:HCP的病因复杂,临床表现多有头痛、肢体抽搐、反应迟钝、言语障碍、记忆障碍、行走不稳、颅神经受损等症状;病理示硬脑膜纤维增生,炎细胞浸润,相应部位脑实质也可有非特异性炎性改变;头颅MRI增强发现典型的影像学改变有利于临床诊断。
- 硬脑膜炎 /
- 病理学,临床 /
- 影像学
Abstract: Objective:To determine the clinical,pathological and radiological features of hypertrophic cranial pachymeningitis (HCP).Methods:The clinical data of 5 patients with HCP were studied retrospectively,and the literature was reviewed.Results:All the 5 patients presented the symptom of headache.Two of them were accompanied by language barriers,1 by limb convulsion,reaction slowness,cranial nerve damage and walking instability,and 1 by memory impairment.MRI scan showed that 2 cases displayed edema changes within the brain parenchyma,and there was a wide range of enhanced thickening in all the 5 cases after enhancement,particularly at the frontal and top of the dura mater,the falx and the tentorium.The brain biopsy of 1 patient showed that the dura mater was significantly thickened,and the dural fibrosis pathology indicated the existence of a large number of plasma cell,lymphocyte,macrophage,neutrophil infiltration and focal calcification,which was considered to be a non-specific chronic inflammation.The brain blood vessels under the dura mater were dilated,with plasma cell and macrophage infiltration.The corresponding brain parenchyma also displayed non-specific inflammatory changes.Conclusions:Causes of HCP are complicated.The common clinical manifestations include headache,body convulsion,reaction slowness,speech impairment,memory impairment,walking instability and cranial nerve damage;Pathology showed dural fibrosis and inflammatory cell infiltration;the corresponding parts of the brain parenchyma may also display non-specific inflammatory changes,and such typical changes in head MRI enhanced imaging is beneficial to clinical diagnosis.
- pachymeningitis /
- pathology,clinical /
- imaging

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肥厚性硬脑膜炎5例报道及文献复习

作者简介: 钱伟东(1967-),女,副主任医师,副教授.

1. 蚌埠医学院第一附属医院神经内科, 安徽蚌埠 233004;
2. 蚌埠医学院第一附属医院放射科, 安徽蚌埠 233004

收稿日期: 2010-02-08

关键词:

摘要: 目的:探讨肥厚性硬脑膜炎(hypertrophic cranial pachymeningitis,HCP)的临床、病理和影像学特点。方法:对5例HCP患者的临床资料结合文献进行回顾性分析。结果:5例患者均表现为头痛,其中2例伴言语障碍;1例伴肢体抽搐,反应迟钝,颅神经受损,行走不稳;1例伴记忆障碍。MRI平扫2例显示脑实质内有水肿改变,增强后5例硬脑膜广泛强化,尤其是额、顶部硬脑膜、大脑镰及小脑幕强化明显。1例行硬脑膜组织活检发现硬脑膜明显增厚,病理示硬脑膜纤维增生,大量浆细胞、淋巴细胞、巨噬细胞、嗜中性粒细胞浸润,灶性钙化,考虑为慢性非特异性炎;"硬膜下方"脑组织血管扩张,浆细胞、巨噬细胞为主的炎细胞浸润,相应部位脑实质也为非特异性炎性改变。结论:HCP的病因复杂,临床表现多有头痛、肢体抽搐、反应迟钝、言语障碍、记忆障碍、行走不稳、颅神经受损等症状;病理示硬脑膜纤维增生,炎细胞浸润,相应部位脑实质也可有非特异性炎性改变;头颅MRI增强发现典型的影像学改变有利于临床诊断。

English Abstract

Hypertrophic cranial pachymeningitis:a report of 5 cases and review of the literature

1. Department of Neurology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China;
2. Department of Radiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China

Received Date: 2010-02-08

Abstract: Objective:To determine the clinical,pathological and radiological features of hypertrophic cranial pachymeningitis (HCP).Methods:The clinical data of 5 patients with HCP were studied retrospectively,and the literature was reviewed.Results:All the 5 patients presented the symptom of headache.Two of them were accompanied by language barriers,1 by limb convulsion,reaction slowness,cranial nerve damage and walking instability,and 1 by memory impairment.MRI scan showed that 2 cases displayed edema changes within the brain parenchyma,and there was a wide range of enhanced thickening in all the 5 cases after enhancement,particularly at the frontal and top of the dura mater,the falx and the tentorium.The brain biopsy of 1 patient showed that the dura mater was significantly thickened,and the dural fibrosis pathology indicated the existence of a large number of plasma cell,lymphocyte,macrophage,neutrophil infiltration and focal calcification,which was considered to be a non-specific chronic inflammation.The brain blood vessels under the dura mater were dilated,with plasma cell and macrophage infiltration.The corresponding brain parenchyma also displayed non-specific inflammatory changes.Conclusions:Causes of HCP are complicated.The common clinical manifestations include headache,body convulsion,reaction slowness,speech impairment,memory impairment,walking instability and cranial nerve damage;Pathology showed dural fibrosis and inflammatory cell infiltration;the corresponding parts of the brain parenchyma may also display non-specific inflammatory changes,and such typical changes in head MRI enhanced imaging is beneficial to clinical diagnosis.