Spinal Hypertrophic Pachymeningitis Causing Thoracic Myelopathy in a Patient of Takayasu Arteritis: A Case Report

JBJS Case Connect. 2021 Nov 11;11(4). doi: 10.2106/JBJS.CC.21.00520.

Abstract

Case: A 52-year-old man presented with thoracic myelopathy, and his magnetic resonance imaging (MRI) was suggestive of T1-T4 hypertrophic-pachymeningitis. Incidentally, circumferential thickening of the infra-renal abdominal aorta and right common iliac artery was seen, which along with the findings in a contrast computed tomography was consistent with Takayasu arteritis (TA). The patient underwent T1-T4 laminectomy, thinning of dura, biopsy, and steroid therapy. At the 1-year follow-up, he was asymptomatic and MRI revealed resolution of the lesion.

Conclusion: This is the first report describing an association between TA and hypertrophic spinal pachymeningitis, emphasizing the unusual neurological manifestation of myelopathy and complete resolution of symptoms with timely and appropriate intervention.

Publication types

  • Case Reports

MeSH terms

  • Dura Mater / pathology
  • Humans
  • Hypertrophy / complications
  • Hypertrophy / pathology
  • Male
  • Meningitis* / diagnostic imaging
  • Meningitis* / etiology
  • Middle Aged
  • Spinal Cord Diseases* / diagnostic imaging
  • Spinal Cord Diseases* / etiology
  • Spinal Cord Diseases* / surgery
  • Takayasu Arteritis* / complications
  • Takayasu Arteritis* / diagnostic imaging
  • Takayasu Arteritis* / pathology