Craniocervical hypertrophic pachymeningitis.

BACKGROUND

Hypertrophic pachymeningitis (HP) is a rare neurological disorder characterized by dural thickening. Here, we discuss the diagnosis and surgical management of a 38-year-old whose myelopathy was attributed to dorsally compressive HP extending from the lower cerebellar fossa to C3.

CASE DESCRIPTION: A 38-year-old male with Sjögren's syndrome presented with cervical pain, upper limb paresis, dysphagia, and left-sided tongue/palate paralysis. The cervical magnetic resonance (MR) showed a dorsally compressive lower cerebellar fossa to C3 lesion. When the biopsy revealed HP, and once conservative treatment failed, the patient successfully underwent a posterior surgical decompression, lesion debulking, and craniocervical fusion.

CONCLUSION

Cervical HPs should be diagnosed early on MR, and those with significant myelopathy, aggressively surgically treated.