Objective To investigate the clinical features, pathogenesis, cerebrospinal fluid (CSF) changes, radiological findings and treatments of hypertrophic pachymeningitis. Methods The clinical information of 8 patients with hypertrophic pachymeningitis was retrospectively analyzed and the references were reviewed. Results The symptom onset in the 8 patients was ranged from 43 to 78 years old. 6 patients presented headache, and 2 presented dizziness. 6 patients showed cranial nerve damages, and 4 patients showed glossopharyngeal and vagus nerve damages. The sedimentation rate increased in 5 cases. The protein and white blood cells in CSF increased in 4 cases. All cultures and stains for bacteria, tuberculosis, fungi and tumor cells were negative. MRI scan showed brain parenchyma edema in 1 case, and widespread enhanced thickening in 7 cases after enhancement, particularly at the frontal, top of the duramater, the falx and the tentorium. Corticosteroid therapy released headache in all cases, and partly relieved other neurological symptoms and signs in 4 cases. Conclusions The causes of hypertrophic pachymeningitis are complicated. The common clinical manifestations include headache and cranial nerve damages. The typical changes in contrasted brain MRI are helpful for clinical diagnosis. Corticosteroid therapy is effective.%目的 探讨肥厚性硬膜炎的发病机制、临床特点、脑脊液和影像学改变及治疗.方法 回顾性分析8例肥厚性硬膜炎患者的临床资料并复习文献.结果 8例患者发病年龄为43～78岁,6例患者均有头痛,2例患者以头晕为主要症状,6例患者存在脑神经受累表现,其中舌咽神经、迷走神经受累4例.血生化检查红细胞沉降率增快5例.腰穿脑脊液检查示压力增高4例,蛋白、细胞数增高；8例患者均未查到结核杆菌、隐球菌、瘤细胞.头MRI及增强扫描示广泛硬脑膜增厚强化.经糖皮质激素治疗后头痛缓解,脑神经受累症状部分好转.结论 肥厚性硬膜炎病因复杂,临床多表现为头痛,脑神经易受累,头颅MRI增强发现典型的影像学改变有利于临床诊断,糖皮质激素治疗有效.
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