误导性特发性肥厚性脑积水罕见病例。

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL
Case Reports in Medicine Pub Date : 2024-03-13 eCollection Date: 2024-01-01 DOI:10.1155/2024/5561686
Ahmad Rezaee Azandaryani, Amir Mohammad Salehi
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引用次数: 0

摘要

特发性肥厚性硬脑膜炎(IHP)是一种罕见的硬脑膜弥漫性增厚疾病,没有特异的临床症状和表现,导致神经外科医生误诊。一名 4 岁女孩因言语困难和剧烈头痛到我院急诊就诊。入院时头部计算机断层扫描(CT 扫描)显示右侧颞顶区有大量积液,并伴有肿块效应,神经外科医生为其引流,初步诊断为硬膜下血肿。然而,术后 CT 扫描显示手术引流失败,因此患者要求进行磁共振成像(MRI)检查。核磁共振成像发现患者右侧硬脑膜弥漫性结节性增厚,伴有内部间隔和不同的内部出血期,但无脑实质受累的证据,根据血清学和自身免疫筛查试验,患者被诊断为 IHP。患者接受了开颅手术。神经系统症状立即得到改善。随访3个月后,患者的临床和影像学状况良好。IHP 应作为某些非交流性脑积水病例的鉴别诊断之一;然而,该疾病的罕见性和缺乏特异性临床症状使得诊断非常困难。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Misleading Rare Case of Idiopathic Hypertrophic Pachymeningitis.

Idiopathic hypertrophic pachymeningitis (IHP) is a rare disease with diffuse thickening of the dura mater that has no specific clinical symptoms and manifestations and it causes neurosurgeons to misdiagnose. A 4-year-old girl presented at the emergency room of our hospital with speech difficulty and severe headache. Head computed tomography scans (CT scan) on admission revealed a large fluid collection over the right temporoparietal region with mass effect, and the neurosurgeon drained it with the initial diagnosis of subdural hematoma. However, the postoperative CT scan demonstrated the failure of surgical drainage; therefore, magnetic resonance imaging (MRI) was requested for the patient. MRI identified diffuse nodular dural thickening with internal septations and different internal hemorrhagic stages on the right side with no evidence of brain parenchymal involvement and according to the serology and autoimmune screening tests, and IHP was diagnosed for the patient. The patient underwent craniotomy. There was an immediate improvement of neurologic symptoms. The patient had good clinical and radiologic outcome at 3 -months follow-up. IHP should be part of the differential diagnosis of some cases of noncommunicating hydrocephalus; however, the rarity of the disease and the absence of specific clinical symptoms make the diagnosis difficult.

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来源期刊
Case Reports in Medicine
Case Reports in Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
1.70
自引率
0.00%
发文量
53
审稿时长
13 weeks
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