Cranio-Cervical Idiopathic Hypertrophic Pachymeningitis: A Case Report and Review of Literature

Background Data: Cranio-cervical pachymeningitis is a rare and challenging disorder. Management of this condition is still under research. Purpose: To follow a case of cranio-cervical pachymeningitis and to decide the optimal management method and factors affecting outcome and prognosis of this condition. Study Design: A case report following surgical result with review of literatures. Patients and Methods: A 56 years old male presented by a progressive cervical myelopathy. MRI cervical spine showed cranio-cervical hypertrophic pachymeningitis with compression on cervical cord. Surgical decompression was done with continuous postoperative clinical and radiological follow-up. Results: Significant clinical improvement was observed after surgical excision. Recurrence happened later with cessation of corticosteroids. After follow up of the patient and review of literatures; factors affecting the prognosis were determined as follow: degree of surgical decompression, continuous use of corticosteroids till full radiological improvement, and development of cranial lesions. Conclusion: Cranio-cervical pachymeningitis is a challenging disorder, management of it should be combined adequate surgical decompression, use of corticosteroids and postoperative rehabilitation program. (2016ESJ116