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

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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]
Copyright of Archivos de Neurociencias is the property of Instituto Nacional de Neurologia y Neurocirugia, Departamento de Publicaciones Cientificas and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Paquimeningitis espinal hipertrófica idiopática: un desafío diagnóstico. Reporte de caso.
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  Data: Idiopathic hypertrophic spinal pachymeningitis: a diagnostic challenge. Case report.
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  Data: <searchLink fieldCode="AR" term="%22Almendárez-Sánchez%2C+César+A%2E%22">Almendárez-Sánchez, César A.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Morales-Valencia%2C+Carlos%22">Morales-Valencia, Carlos</searchLink><relatesTo>1</relatesTo><i> carlosmorales175@hotmail.com</i><br /><searchLink fieldCode="AR" term="%22Álvarez-Vázquez%2C+Leonardo%22">Álvarez-Vázquez, Leonardo</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Gómez-Cano%2C+Arturo+de+J%2E%22">Gómez-Cano, Arturo de J.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Sosa-Nájera%2C+Antonio%22">Sosa-Nájera, Antonio</searchLink><relatesTo>1</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Archivos+de+Neurociencias%22">Archivos de Neurociencias</searchLink>. oct-dic2025, Vol. 30 Issue 4, p189-192. 4p.
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  Data: <searchLink fieldCode="DE" term="%22MENINGITIS+diagnosis%22">MENINGITIS diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22ADRENOCORTICAL+hormones%22">ADRENOCORTICAL hormones</searchLink><br /><searchLink fieldCode="DE" term="%22NEUROLOGIC+examination%22">NEUROLOGIC examination</searchLink><br /><searchLink fieldCode="DE" term="%22BIOPSY%22">BIOPSY</searchLink><br /><searchLink fieldCode="DE" term="%22MENINGITIS%22">MENINGITIS</searchLink><br /><searchLink fieldCode="DE" term="%22IMMUNOGLOBULINS%22">IMMUNOGLOBULINS</searchLink><br /><searchLink fieldCode="DE" term="%22LAMINECTOMY%22">LAMINECTOMY</searchLink><br /><searchLink fieldCode="DE" term="%22TREATMENT+effectiveness%22">TREATMENT effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22MAGNETIC+resonance+imaging%22">MAGNETIC resonance imaging</searchLink><br /><searchLink fieldCode="DE" term="%22BLOOD+sedimentation%22">BLOOD sedimentation</searchLink><br /><searchLink fieldCode="DE" term="%22SPINAL+cord+compression%22">SPINAL cord compression</searchLink><br /><searchLink fieldCode="DE" term="%22MUSCLE+weakness%22">MUSCLE weakness</searchLink><br /><searchLink fieldCode="DE" term="%22NUMBNESS%22">NUMBNESS</searchLink><br /><searchLink fieldCode="DE" term="%22FIBROSIS%22">FIBROSIS</searchLink><br /><searchLink fieldCode="DE" term="%22PAIN%22">PAIN</searchLink><br /><searchLink fieldCode="DE" term="%22HISTOLOGICAL+techniques%22">HISTOLOGICAL techniques</searchLink><br /><searchLink fieldCode="DE" term="%22THORACIC+vertebrae%22">THORACIC vertebrae</searchLink><br /><searchLink fieldCode="DE" term="%22C-reactive+protein%22">C-reactive protein</searchLink><br /><searchLink fieldCode="DE" term="%22REHABILITATION%22">REHABILITATION</searchLink><br /><searchLink fieldCode="DE" term="%22SYMPTOMS%22">SYMPTOMS</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22MEXICO%22">MEXICO</searchLink>
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: 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]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: 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]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of Archivos de Neurociencias is the property of Instituto Nacional de Neurologia y Neurocirugia, Departamento de Publicaciones Cientificas and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.24875/ANC.M24000026
    Languages:
      – Code: spa
        Text: Spanish
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    Subjects:
      – SubjectFull: MENINGITIS diagnosis
        Type: general
      – SubjectFull: ADRENOCORTICAL hormones
        Type: general
      – SubjectFull: NEUROLOGIC examination
        Type: general
      – SubjectFull: BIOPSY
        Type: general
      – SubjectFull: MENINGITIS
        Type: general
      – SubjectFull: IMMUNOGLOBULINS
        Type: general
      – SubjectFull: LAMINECTOMY
        Type: general
      – SubjectFull: TREATMENT effectiveness
        Type: general
      – SubjectFull: MAGNETIC resonance imaging
        Type: general
      – SubjectFull: BLOOD sedimentation
        Type: general
      – SubjectFull: SPINAL cord compression
        Type: general
      – SubjectFull: MUSCLE weakness
        Type: general
      – SubjectFull: NUMBNESS
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      – SubjectFull: FIBROSIS
        Type: general
      – SubjectFull: PAIN
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      – SubjectFull: HISTOLOGICAL techniques
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        Type: general
      – SubjectFull: MEXICO
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      – TitleFull: Paquimeningitis espinal hipertrófica idiopática: un desafío diagnóstico. Reporte de caso.
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