A successful case of hypertrophic cranial pachymeningitis treated by optic nerve decompression

Takashi Horiguchi, Kazuhiro Gotoh, Kazunari Yoshida, Shigeo Toya

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Abstract

A successful direct operation in a case of hypertrophic cranial pachymeningitis (HCP) is described. A 51-year-old male was admitted with right visual disturbance. CT scanning revealed a mass lesion in the right middle cranial fossa extending into the right orbita. From MRI it was ascertained that this mass lesion consisted of thickening of the skull base dura. The effect of steroids was transient and his visual disturbance was rapidly increasing. A direct operation was performed consisting of partial dissection of the thickening dura and decompression of the right optic nerve. Histological diagnosis showed HCP. After surgery his symptoms dramatically improved. The etiology, and natural course and treatment of HCP are well reported in the literature. In the present case the etiology was not clear, but there was a possible relationship with intraorbital pseudotumor or multifocal fibrosclerosis. The reported occasional transitory effect of steroids on HCP and a poor prognosis for visual acuity are common traits in these patients. The authors thus feel that a direct operation should be immediately carried out when the effect of steroids on visual disturbances associated with HCP is judged transient.

Original languageEnglish
Pages (from-to)281-285
Number of pages5
JournalNeurological Surgery
Volume24
Issue number3
Publication statusPublished - 1996 Mar 1

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Keywords

  • etiology
  • hypertrophic cranial pachymeningitis
  • prognosis
  • treatment
  • visual disturbance

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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