caa a22 4500 445356251 CHVBK 20180317142901.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s10072-010-0343-0 doi (NATIONALLICENCE)springer-10.1007/s10072-010-0343-0 A case of subarachnoid hemorrhage with pituitary apoplexy caused by idiopathic hypertrophic pachymeningitis [Elektronische Daten] [Shoko Yamada, Makoto Aoki, Makoto Nakane, Hitoshi Nakayama] Steroid therapy is considered to improve clinical symptoms in hypertrophic pachymeningitis. We present a 70-year-old man with idiopathic hypertrophic pachymeningitis, whose clinical signs progressively worsened despite steroid therapy. He died of subarachnoid hemorrhage (SAH) with pituitary apoplexy 2months after the admission regardless of improvement of laboratory data and magnetic resonance imaging appearance by one-and-half-month steroid therapy. Autopsy revealed thickened dura mater supporting the diagnosis of hypertrophic pachymeningitis. Brain parenchyma is generally not affected by the disease; however, histological investigation suggested that inflammation of the dura caused damage to superior hypophyseal artery resulting in SAH and apoplexy in the anterior lobe of the pituitary gland. The higher dose and the longer duration of steroid therapy should have achieved in our case although most laboratory data recovered within the normal range. The aggressiveness of hypertrophic pachymeningitis must be evaluated by clinical signs rather than by laboratory data or imaging examinations. Springer-Verlag, 2010 Hypertrophic pachymeningitis nationallicence Pituitary apoplexy nationallicence Steroid nationallicence Skull base nationallicence Hypopituitarism nationallicence Neuropathy nationallicence Yamada Shoko Department of Neurosurgery, Teikyo University Mizonokuchi Hospital, 3-8-3 Mizonokuchi, Takatsu-ku, 213-8507, Kawasaki, Kanagawa, Japan aut Aoki Makoto Department of Neurosurgery, Teikyo University Mizonokuchi Hospital, 3-8-3 Mizonokuchi, Takatsu-ku, 213-8507, Kawasaki, Kanagawa, Japan aut Nakane Makoto Department of Neurosurgery, Teikyo University Mizonokuchi Hospital, 3-8-3 Mizonokuchi, Takatsu-ku, 213-8507, Kawasaki, Kanagawa, Japan aut Nakayama Hitoshi Department of Neurosurgery, Teikyo University Mizonokuchi Hospital, 3-8-3 Mizonokuchi, Takatsu-ku, 213-8507, Kawasaki, Kanagawa, Japan aut Neurological Sciences Springer Milan 32/3(2011-06-01), 455-459 1590-1874 32:3<455 2011 32 10072 https://doi.org/10.1007/s10072-010-0343-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10072-010-0343-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Yamada Shoko Department of Neurosurgery, Teikyo University Mizonokuchi Hospital, 3-8-3 Mizonokuchi, Takatsu-ku, 213-8507, Kawasaki, Kanagawa, Japan aut NATIONALLICENCE 700 1- Aoki Makoto Department of Neurosurgery, Teikyo University Mizonokuchi Hospital, 3-8-3 Mizonokuchi, Takatsu-ku, 213-8507, Kawasaki, Kanagawa, Japan aut NATIONALLICENCE 700 1- Nakane Makoto Department of Neurosurgery, Teikyo University Mizonokuchi Hospital, 3-8-3 Mizonokuchi, Takatsu-ku, 213-8507, Kawasaki, Kanagawa, Japan aut NATIONALLICENCE 700 1- Nakayama Hitoshi Department of Neurosurgery, Teikyo University Mizonokuchi Hospital, 3-8-3 Mizonokuchi, Takatsu-ku, 213-8507, Kawasaki, Kanagawa, Japan aut NATIONALLICENCE 773 0- Neurological Sciences Springer Milan 32/3(2011-06-01), 455-459 1590-1874 32:3<455 2011 32 10072 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer