Rapidly progressive fatal idiopathic hypertrophic pachymeningitis with brainstem involvement in a child

Childs Nerv Syst. 2018 Sep;34(9):1795-1798. doi: 10.1007/s00381-018-3819-5. Epub 2018 May 5.

Abstract

Background: Hypertrophic pachymeningitis (HP) is a rare disorder characterized by diffuse thickening of the dura mater with resultant neurologic deficits. HP develops secondary to various conditions or idiopathically usually in adults but rarely in children.

Case report: We describe a 3-year-old female child with idiopathic HP. Her HP involved the entire central nervous system with progression into the brainstem. The lesion responded poorly to pulsed steroids or any immunosuppressants. The brainstem lesion grew rapidly and formed various nodules that ultimately resulted in brain death. This is the first fatal case of HP in a child.

Keywords: Brain death; Brainstem lesion; Hypertrophic pachymeningitis; Pediatric.

Publication types

  • Case Reports

MeSH terms

  • Accidental Falls*
  • Brain Stem / diagnostic imaging*
  • Child, Preschool
  • Disease Progression*
  • Fatal Outcome
  • Female
  • Humans
  • Hypertrophy / diagnostic imaging
  • Hypertrophy / etiology
  • Hypertrophy / surgery
  • Meningitis / diagnostic imaging*
  • Meningitis / etiology
  • Meningitis / surgery*
  • Time Factors