Idiopathic hypertrophic cranial pachymeningitis: a rare but treatable cause of headache and facial pain

Introduction Idiopathic Hypertrophic Cranial Pachymeningitis (IHCP) is a rare disease with pain and compression related cranial nerve dysfunction as main clinical features. The leading diagnostic finding of IHCP consists of diffuse or localised thickening of the dura, which demands appropriate imaging and image interpretation. This case description aims at increasing the awareness for the clinical symptoms and imaging findings of this rare disease to allow prompt diagnosis and treatment initiation. Case description An 82-year-old man presented with recurrent left sided headache and worsening facial pain, which had begun more than 1 year ago. Neurological examination at presentation revealed ptosis of the left eye and gaze-induced nystagmus when looking to the left; visual function was intact and no other neurological signs or symptoms were noted. Pre-existing medical conditions included atrial arrhythmia requiring treatment with oral anticoagulants and arterial hypertension. External brain MRI at 1.5T showed diffuse thickening of the dura...
Source: Journal of Neurology, Neurosurgery and Psychiatry - Category: Neurosurgery Authors: Tags: Immunology (including allergy), Meningitis, Brain stem / cerebellum, Cranial nerves, Headache (including migraine), Infection (neurology), Multiple sclerosis, Pain (neurology), Stroke, Hypertension, Ophthalmology, Radiology, Surgical diagnostic tests, Ear Source Type: research