Paquimeningitis espinal hipertrófica idiopática: un desafío diagnóstico. Reporte de caso.

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Bibliographic Details
Title:	Paquimeningitis espinal hipertrófica idiopática: un desafío diagnóstico. Reporte de caso.
Alternate Title:	Idiopathic hypertrophic spinal pachymeningitis: a diagnostic challenge. Case report.
Authors:	Almendárez-Sánchez, César A.¹, Morales-Valencia, Carlos¹ carlosmorales175@hotmail.com, Álvarez-Vázquez, Leonardo¹, Gómez-Cano, Arturo de J.¹, Sosa-Nájera, Antonio¹
Source:	Archivos de Neurociencias. oct-dic2025, Vol. 30 Issue 4, p189-192. 4p.
Subjects:	MENINGITIS diagnosis, ADRENOCORTICAL hormones, NEUROLOGIC examination, BIOPSY, MENINGITIS, IMMUNOGLOBULINS, LAMINECTOMY, TREATMENT effectiveness, MAGNETIC resonance imaging, BLOOD sedimentation, SPINAL cord compression, MUSCLE weakness, NUMBNESS, FIBROSIS, PAIN, HISTOLOGICAL techniques, THORACIC vertebrae, C-reactive protein, REHABILITATION, SYMPTOMS
Geographic Terms:	MEXICO
Abstract (English):	Hypertrophic spinal pachymeningitis is an unusual disease. It may be idiopathic or secondary to other diseases. The main characteristics are chronic inflammation and hypertrophy of the spinal dura mater, with resulting neurological deficits such as sensory and motor alterations. Treatment by surgical decompression combined with systemic steroids has a positive impact. The objective is to report a clinical case of hypertrophic spinal pachymeningitis since it is an extremely rare and little-known entity. A 65-year-old female patient, whose condition began on August 1, 2022, with stabbing pain in the dorsal region, without irradiation, without predominance of time. Three months after the onset of his current condition, there was a decrease in strength in bilateral pelvic limbs 3/5, as well as hypoesthesia in the pelvic limbs. Contrast-enhanced magnetic resonance imaging of the spine is requested; all sequences are reviewed where the contrast-enhanced T1 sequence highlights a lesion that generates narrowing at the level of the thoracic spine with an increase in volume and enhancement of contrast medium from T2 to T10 in the anterior and posterior spinal region. A biopsy of the lesion was obtained, which in the pathology report was concluded as hypertrophic spinal pachymeningitis and treatment with steroids was started immediately. Hypertrophic spinal pachymeningitis is an extremely rare entity, and there is scarce information published in the literature about it. Therefore, making a timely diagnosis to select the most appropriate treatment for patients is important. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	La paquimeningitis espinal hipertrófica es una enfermedad rara. Puede ser idiopática o secundaria a otras enfermedades. La característica principal es la inflamación crónica e hipertrofia de la duramadre espinal con déficits neurológicos resultantes como alteraciones a nivel sensitivo y motor. El tratamiento mediante descompresión quirúrgica aunado a esteroides sistémicos tiene un impacto positivo. El objetivo es reportar un caso clínico de paquimeningitis espinal hipertrófica, ya que es una entidad extremadamente rara y poco conocida. Paciente de sexo femenino de 65 años, que inicia su padecimiento el 1 de agosto del 2022, con dolor en región dorsal de tipo punzante, sin irradiaciones, sin predominio de horario. Tres meses posteriores al inicio de su padecimiento actual se agrega disminución de la fuerza en miembro pélvicos bilaterales 3/5, así como hipoestesia en miembros pélvicos. Se solicita resonancia magnética contrastada de columna, se revisan todas las secuencias en donde resalta en secuencia T1 contrastada lesión que genera estrechamiento a nivel de columna torácica con aumento de volumen y refuerzo al medio de contraste desde T2 hasta T10 en región medular anterior y posterior. Se obtiene biopsia de la lesión, la cual en reporte de patología se concluye como paquimeningitis espinal hipertrófica, y se inicia de forma inmediata tratamiento con esteroides. La paquimeningitis espinal hipertrófica es una entidad extremadamente rara, en la que existe poca información publicada en la literatura. Por lo que es de importancia realizar el diagnóstico oportuno para seleccionar el tratamiento más adecuado para los pacientes. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	Hypertrophic spinal pachymeningitis is an unusual disease. It may be idiopathic or secondary to other diseases. The main characteristics are chronic inflammation and hypertrophy of the spinal dura mater, with resulting neurological deficits such as sensory and motor alterations. Treatment by surgical decompression combined with systemic steroids has a positive impact. The objective is to report a clinical case of hypertrophic spinal pachymeningitis since it is an extremely rare and little-known entity. A 65-year-old female patient, whose condition began on August 1, 2022, with stabbing pain in the dorsal region, without irradiation, without predominance of time. Three months after the onset of his current condition, there was a decrease in strength in bilateral pelvic limbs 3/5, as well as hypoesthesia in the pelvic limbs. Contrast-enhanced magnetic resonance imaging of the spine is requested; all sequences are reviewed where the contrast-enhanced T1 sequence highlights a lesion that generates narrowing at the level of the thoracic spine with an increase in volume and enhancement of contrast medium from T2 to T10 in the anterior and posterior spinal region. A biopsy of the lesion was obtained, which in the pathology report was concluded as hypertrophic spinal pachymeningitis and treatment with steroids was started immediately. Hypertrophic spinal pachymeningitis is an extremely rare entity, and there is scarce information published in the literature about it. Therefore, making a timely diagnosis to select the most appropriate treatment for patients is important. [ABSTRACT FROM AUTHOR]
ISSN:	10285938
DOI:	10.24875/ANC.M24000026