Idiopathic hypertrophic pachymeningitis – case report
1 Klinika Neurologii i Epileptologii II Katedry Chorób Układu Nerwowego Uniwersytetu Medycznego w Łodzi
2 Klinika Neurochirurgii i Chirurgii Nerwów Obwodowych
3 Zakład Patomorfologii i Cytopatologii Klinicznej
AKTUALN NEUROL 2011, 11 (2), p. 79-84

Idiopathic hypertrophic pachymeningitis (IHPM) is a rare disaster, with still unknown aetiopathogenesis. There are above 100 described cases of IHPM in the medical literature till 2010 year of which majority was reported in last 10 years. We would like to present a case of 52 years old woman admitted to Department of Neurology and Epileptology, Medical University of Lodz in August 2010. The disease was started with weakening of visual acuity in 2007 year in left eye. Because of this she was hospitalised in ophthalmology ward and after that at neurological ward, but the reason for weakening of visual acuity was unclear. She had had numerous CT scans of head, which were correct always. In May 2009 she was given an cardiostimulator because of cardiologic disease, which excluded ability to future MRI examination. In August 2009 she was diagnosed a total atrophy of left optical nerve and beginning of atrophy of right optical nerve.In February headaches change from occasional to every day pains. After she was admitted to hospital the CT scan of head showed cerebral haematoma. Although the existing symptoms of pressure to the right lateral ventricle with its displacement but she was not qualified to the operation by neurosurgeon. In August 2010 after another hospitalisation because lack of evolution of haematoma and increasing displacement she was transferred to the Neurosurgery Department. During the surgery stated thicker dura mater about 7 mm, which fragments were sent to pathomorphological examination. They showed changes of a fibrogranular nature. Many other laboratory test were made to discover cause of IHPM and they were negative, that proof the idiopathic hypertrophic pachymeningitis diagnosis.

Keywords: pachymeningitis hypertrophica, atrophia nervi opici, haematoma cerebral, headaches