Abstract
A 44-year-old female presented with a rare tuberculous hypertrophic pachymeningitis involving the posterior fossa and high cervical region manifesting as progressive multiple cranial nerve pareses and myelopathy developing over 6 months. Magnetic resonance imaging demonstrated the thickened dura mater and associated syrinx. Despite decompressive craniectomy and antituberculous treatment, she died of disseminated intravascular coagulation. Hypertrophic pachymeningitis is probably best treated by the most extensive excision of affected dura mater possible, unless medical treatment can be instituted for an identifiable underlying causative disease.
MeSH terms
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Adult
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Antitubercular Agents / therapeutic use
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Cervical Vertebrae* / pathology
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Combined Modality Therapy
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Cranial Fossa, Posterior
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Craniotomy
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Diagnosis, Differential
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Dura Mater / pathology
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Fatal Outcome
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Female
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Humans
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Laminectomy
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Magnetic Resonance Imaging
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Medulla Oblongata / pathology
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Neurologic Examination
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Spinal Cord / pathology
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Spinal Cord Compression / diagnosis
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Spinal Cord Compression / pathology
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Spinal Cord Compression / surgery
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Tuberculosis, Meningeal / diagnosis*
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Tuberculosis, Meningeal / pathology
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Tuberculosis, Meningeal / surgery
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Tuberculosis, Spinal / diagnosis*
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Tuberculosis, Spinal / pathology
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Tuberculosis, Spinal / surgery