Idiopathic Hypertrophic Cranial Pachymeningitis Presenting With Headache

Authors

  • So-Hyang Im MD,

    1. From the Department of Neurosurgery, Dongguk University Hospital, Gyeonggi-do, Korea (S.-H. Im and K.-T. Cho); Department of Radiology, Dongguk University Hospital, Gyeonggi-do, Korea (H.S. Seo); Department of Pathology, Dongguk University Hospital, Gyeonggi-do, Korea (J.-S. Choi).
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  • Keun-Tae Cho MD,

    1. From the Department of Neurosurgery, Dongguk University Hospital, Gyeonggi-do, Korea (S.-H. Im and K.-T. Cho); Department of Radiology, Dongguk University Hospital, Gyeonggi-do, Korea (H.S. Seo); Department of Pathology, Dongguk University Hospital, Gyeonggi-do, Korea (J.-S. Choi).
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  • Hyung Suk Seo MD,

    1. From the Department of Neurosurgery, Dongguk University Hospital, Gyeonggi-do, Korea (S.-H. Im and K.-T. Cho); Department of Radiology, Dongguk University Hospital, Gyeonggi-do, Korea (H.S. Seo); Department of Pathology, Dongguk University Hospital, Gyeonggi-do, Korea (J.-S. Choi).
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  • Jong-Sun Choi MD

    1. From the Department of Neurosurgery, Dongguk University Hospital, Gyeonggi-do, Korea (S.-H. Im and K.-T. Cho); Department of Radiology, Dongguk University Hospital, Gyeonggi-do, Korea (H.S. Seo); Department of Pathology, Dongguk University Hospital, Gyeonggi-do, Korea (J.-S. Choi).
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  • Conflict of interest: None

S.-H. Im, Department of Neurosurgery, Dongguk University Hospital, 814 Siksa-dong, Ilsandong-ku, Gyeonggi-do, 410–773, Korea.

Abstract

Idiopathic hypertrophic cranial pachymeningitis is a rare inflammatory disease, usually involving the dura mater of skull base, tentorium, and falx. Chronic headache is the most common clinical manifestations. We report a case of idiopathic hypertrophic cranial pachymeningitis that was, initially, misdiagnosed as acute subdural hematoma along the tentorium cerebelli and posterior falx on the brain precontrast CT scan of a patient with severe headache. Correct diagnosis of pachymeningitis was made only after brain magnetic resonance imaging and meningeal biopsy.

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