Hypertrophic pachymeningitis, cerebral or spinal, is a much rarer type of neurosyphilis than the vascular or leptomeningeal forms. In the present case the pathologic process not only involved the larger portion of the cerebral dura and its falx, but extended to the tentorium, pons, medulla and upper portion of the spinal cord. Regardless of such an extensive involvement, the clinical signs and symptoms were meager and, like the histologic changes, were unique.
REPORT OF CASE
—A white man aged 44, who always had been in good health, was admitted to the Cook County Hospital on Feb. 26, 1938, because of severe headaches of four months' duration and loss of weight. The headaches were frontal, occasionally occipital, and were especially severe in the evening, when they would become "sharp" and increase on coughing. About three and one-half months after the onset of the headaches, the patient commenced to experience difficulties
Hassin GB, Zeitlin H. SYPHILITIC CEREBRAL HYPERTROPHIC PACHYMENINGITISClinicopathologic Studies in a Case. Arch NeurPsych. 1940;43(2):362-371. doi:10.1001/archneurpsyc.1940.02280020170015