polenovjournalРоссийский нейрохирургический журнал имени профессора А. Л. ПоленоваRussian Neurosurgical Journal named after Professor A. L. Polenov2071-2693Семинары, Конференции и Форумы10.56618/20712693_2022_14_4_111polenovjournal-162Research ArticleКЛИНИЧЕСКИЙ СЛУЧАЙA CASE REPORTГипертрофический базальный пахименингит, распространенный на орбиту, в сочетании с синдромом Толоса-Ханта: описание клинического случаяHypertrophic basal pachymeningitis, spread into orbit, in combination with Tolosa-Hunt syndrome: description of a clinical casehttps://orcid.org/0000-0003-3827-8676ИвановВ. В.IvanovV. V.

Иванов Владислав Вадимович.

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Vladislav V. Ivanov.

2/1 Barrikadnaya St., Moscow, 125993

https://orcid.org/0000-0002-0978-4353ШестаковА. А.ShestakovA. A.

Шестаков Андрей Александрович.

125284, Москва, 2-й Боткинский пр., вл. 5; 125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Andrey A. Shestakov.

2/1 Barrikadnaya St., Moscow, 125993

https://orcid.org/0000-0002-3593-7034ГорожанинА. В.GorozhaninA. V.

Горожанин Александр Вадимович.

125284, Москва, 2-й Боткинский пр., вл. 5; 125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Aleksandr V. Gorozhanin.

2/1 Barrikadnaya St., Moscow, 125993

https://orcid.org/0000-0002-7536-3661МухинаО. В.MukhinaO. V.

Мухина Ольга Владимировна.

125284, Москва, 2-й Боткинский пр., вл. 5; 125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Olga V. Mukhina.

2/1 Barrikadnaya St., Moscow, 125993

https://orcid.org/0000-0002-8944-9837ДревальО. Н.DrevalO. N.

Древаль Олег Николаевич.

125284, Москва, 2-й Боткинский пр., вл. 5; 125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Oleg N. Dreval.

2/1 Barrikadnaya St., Moscow, 125993

ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияRussian Medical Academy of Postgraduate Education, Ministry of Health of RussiaRussian FederationГородская клиническая больница имени С.П. Боткина Департамента здравоохранения города Москвы; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияBotkin Moscow City Clinical Hospital; Russian Medical Academy of Postgraduate Education, Ministry of Health of RussiaRussian Federation202210082024144111116Copyright © Иванов В.В., Шестаков А.А., Горожанин А.В., Мухина О.В., Древаль О.Н., 20242024Иванов В.В., Шестаков А.А., Горожанин А.В., Мухина О.В., Древаль О.Н.Ivanov V.V., Shestakov A.A., Gorozhanin A.V., Mukhina O.V., Dreval O.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://polenovjournal.elpub.ru/jour/article/view/162

В представленной работе описан опыт лечения пациента с гипертрофическим базальным пахименингитом, распространенным на структуры орбиты, в сочетании с синдромом Толоса-Ханта. Приведен анализ тактики хирургического лечения при данном заболевании в мировой литературе. Гипертрофический базальный пахименингит — хроническое воспалительное заболевание, вызывающее диффузный фиброз и увеличение твердой мозговой оболочки. В крайне редких случаях по клинической картине данное заболевание может сочетаться с синдромом Толоса-Ханта за счет сдавления структур, проходящих через верхнюю глазничную щель, что затрудняет постановку основного диагноза. Пациенту было выполнено хирургическое вмешательство с декомпрессией мягкотканных структур орбиты, зрительного нерва и взятием биопсии для определения гистологической структуры образования, в послеоперационном периоде отмечен регресс неврологического дефицита. Сочетание синдрома Толоса-Ханта и гипертрофического базального пахименингита встречается очень редко, увеличение количества описанных случаев позволит создать алгоритмы диагностики и лечения данного заболевания.

The presented work describes the experience of treating a patient with hypertrophic basal pachymeningitis, spread to the structures of the orbit, in combination with Tolosa-Hunt syndrome. The analysis of the tactics of surgical treatment for this disease in the world literature is given. Hypertrophic basal pachymeningitis is a chronic inflammatory disease that causes diffuse fibrosis and enlargement of the dura mater. In extremely rare cases, according to the clinical picture, this disease can be combined with Tolosa-Hunt syndrome due to compression of structures passing through the upper orbital fissure, which makes it difficult to make a basic diagnosis. The patient underwent surgical intervention with decompression of soft tissue structures of the orbit, optic nerve and taking a biopsy to determine the histological structure of the formation, a regression of neurological deficit was noted in the postoperative period. The combination of Tolosa-Hunt syndrome and hypertrophic basal pachymeningitis is very rare, an increase in the number of described cases will allow creating algorithms for the diagnosis and treatment of this disease.

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The authors declare that there are no conflicts of interest present.