TITLE:
Idiopathic hypertrophic pachymeningitis with intracranial hypotension and distension of anterior internal vertebral venous plexus are associated with positional headaches but not sufficient in the diagnosis
AUTHORS:
Yongpeng Yu, Changkai Sun, Chen Zhang, Hongqin Zhao, Thian C. Ng
KEYWORDS:
Idiopathic; Pachymeningitis; Intracranial Hypotension
JOURNAL NAME:
World Journal of Neuroscience,
Vol.3 No.3,
July
19,
2013
ABSTRACT:
Idiopathic hypertrophic pachymeningitis (IHP) is a
very infrequent disorder that causes a localized or diffuse thickening of the
dura mater. The main clinical features of IHP at presentation include headache,
cranial nerve involvement, ataxia, transient ischemic attacks (TIA) and
seizures. Intracranial hypotension (ICH) and distension of anterior internal
vertebral venous plexus (IVVP) have not previously been reported as the main
clinical manifestations. We report a unique case with these characteristics as
the main clinical findings, and investigate the internal relationship between these characteristics. This study highlights the heterogeneity of IHP, in terms of clinical, imaging, and
pathological features. We recommend that dural biopsies should be considered in
patients with clinically typical orthostatic headache and (or) diffuse
pachymeningeal enhancement on magnetic resonance imaging (MRI) for the
diagnosis of IHP.