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Intraventricular cytarabine in a case of idiopathic hypertrophic pachymeningitis
  1. I Kleiter1,
  2. V H Hans4,
  3. G Schuierer2,
  4. J Marienhagen3,
  5. P Hau1,
  6. H Schütz5,
  7. U Bogdahn1,
  8. A Steinbrecher1
  1. 1Department of Neurology, University of Regensburg, Regensburg, Germany
  2. 2Institute of Neuroradiology, University of Regensburg
  3. 3Department of Nuclear Medicine, University of Regensburg
  4. 4Institute of Neuropathology, University of Bonn, Bonn, Germany
  5. 5Department of Neurology, Städtische Kliniken Frankfurt am Main – Höchst, Germany
  1. Correspondence to:
 Dr I Kleiter
 University of Regensburg, Department of Neurology, Universitätsstrasse 84, 93042 Regensburg, Germany; ingo.kleiterklinik.uni-regensburg.de

Abstract

Idiopathic hypertrophic chronic pachymeningitis (IHCP) is characterised by inflammatory fibrotic thickening of the dura mater. Long term management is controversial. A 28 year old man with craniospinal IHCP and prominent lymphocytic meningitis is reported. Cerebrospinal fluid and histological examination suggested a CD4+ T cell driven process and B cell stimulation. After surgical, tuberculostatic, and immunosuppressive treatment failed to control the progressive meningeal hypertrophy, causing severe headache and neurological disability, the disease process eventually abated with intraventricular cytarabine treatment.

  • pachymeningitis
  • lymphoplasmacyte-rich meningioma
  • cytarabine

https://doi.org/10.1136/jnnp.2003.024653

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    Footnotes

    • Competing interests: none declared

    • I Kleiter and V H Hans contributed equally to this work.