Hypertrophic Pachymeningitis Case Report And Clinical Analysis Of 78 Cases

Objective: The objective of the research were to analyze the clinical features and imaging features and other coverage of hypertrophic pachymeningitis and the value of the glucocorticoid in the treatment of hypertrophic pachymeningitis,the paper aims to report one case of hypertrophic pachymeningitis combined with 77 cases reported in the domestic in the past 20 years.The paper also aims to improve C linical work for understanding the knowledge of hypertrophic pachymeningitis.Methods : 1.To explore and analyze the clinical and imaging features,we report one case of the form of one case of hypertrophic pachymeningitis.2.We choose the case reports of hypertrophic pachymeningitis from the historical domestic from 1995 to 2015 in our country in the form of system review.The cases which fit the requirement should clarify the statement of criteria inclusion,and make interventions,control the research methods of clinical characteristics and prognosis.3.We make specific record from one case hypertrophic pachymeningitis in our hospital and other cases from the domestic,which are including demographic characteristics(gender,age),clinical features(a variety of clinical signs),clinical history,personal history,imaging characteristics(anatomical site and responsibility lesions),laboratory tests and clinical outcome.4.The clinical features,sex and imaging features apply dichotomous data,and the age apply the continuity data.The imaging data CT value and the length is measured by AW4.5 workstation viewer measurement in the hospital.C linical prognosis are divided in two levels called “sustained remission type " and " recurrent type ”,In order to contrast datas,we use the statistical software and method.Results: The result of the one case reported:(1)the results of clinical diagnosis and treatment :The patient treated in our hospitial has the 3 year hypertrophic pachymeningitis.And he is treated in our hospital for four times,misdiagnosis hospitalized three times,coverage in 3 years.In the three year,the next diagnosis of glucocorticoid,headache and other symptoms were relieved,and the short-term prognosis is good.(2)Imaging findings:Neuroimaging examination is normal within a half month.2 years and 3 years after the start,imaging were seen tutorial higher density,the CT value is 55 Hu and 48 Hu,the maximum width is 2.98 cm and 2.38 cm.After glucocorticoid therapy for 10 days,examination showed tentorial density level was lower,the CT value is 40 Hu,with a maximum width of 0.94 cm.The results of 78 patients,as clinical features analyzing.demographic characteristics,clinical symptoms,signs and imaging features result: an opt-in case and 78 cases showed: 78 patients with hypertrophic pachymeningitis than men female,male to female ratio is 2: 1;mean age: 47.9 years.Headache,nerve damage,eye movement limited,vision loss,hearing loss and other symptoms as the main symptoms of ataxia,pathological signs were positive,increased intracranial pressure,etc.the main signs of clinical signs,tentorium,falx and other parts of the imaging features of the main disease site.(2)The contrast of different Clinical types hypertrophic pachymeningitis:55 patients sustained remission type(70.5%)and others remain recurrent type 23 cases(29.5%).Because of the age of the continuity of data,two normally distributed,it is given a separate T test results showed that: There was no significant difference between the two groups(P = 0.376,P> 0.05).The differenece between pathological positive and meningeal irritation-positive patients was statistically significant(P = 0.015 and P = 0.045,P <0.05),all other clinical data were compared between the two groups,there are no differences between the two groups(P> 0.05).(3)The treatment with sub-type of prognosis findings contrast:70 cases were divided in two parts,the application of Glucocorticoid therapy into the treatment group of 57 cases and non-glucocorticoid treatment group of 13 patients.The performance of 57 patients with steroid-treated patients on Glucocorticoid therapy.Sustained reliving: 44 cases(77.2%),Repeatedly: 13 cases(22.8%).And non-glucocorticoid treatment group show Sustained reliving:6 patients(46.2%),Repeatedly:7 cases(53.8%).The result show that the difference between glucocorticoid group and non-glucocorticoid group was statistically significant(P=0.040,P<0.05)?Conclusions: 1.Hypertrophic pachymeningitis is one kind of chornic disease,the main clinical feature of the disease is repeated headache.2.The lesions invloved the tentorium,therefore Neurological imaging mostly dominated tentorial increased density.3.Glucocorticoid therapy could improve clinical outcomes.The positive of pathological sign and the postive of Kernig sign often indicates a poor clinical outcome.