Hypertrophic pachymeningitis: management

Evidence-based neurology checklist on hypertrophic pachymeningitis: management: Magnetic resonance imaging (MRI) This shows dural enhancement It may also show the ‘Eiffel-by-night’ sign Cerebrospinal fluid (CSF) analysis: features Dural biopsy Treatment

Magnetic resonance imaging (MRI)

  • This shows dural enhancement
  • It may also show the ‘Eiffel-by-night’ sign

Cerebrospinal fluid (CSF) analysis: features

Dural biopsy

Treatment

References

  1. Kupersmith, MJ, Martin V, Heller G, Shah A, Mitnick HJ. Idiopathic hypertrophic pachymeningitis. Neurology 2004; 62:686-694.
  2. Thomas B, Thamburaj K, Kesavadas C. 'Eiffel-by-night': a new MR sign demonstrating reactivation in idiopathic hypertrophic pachymeningitis. Neuroradiol J 2007; 20:194-195. 
  3. Maher M, Zanazzi G, Faust P, Nickerson K, T Wong T. IgG4-related hypertrophic pachymeningitis of the spine with MPO-ANCA seropositivity. Clin Imaging 2017; 46:108-112.
  4. Jang Y, Lee ST, Jung KH, Chu K, Lee SK. Rituximab treatment for idiopathic hypertrophic pachymeningitis. J Clin Neurol 2017; 13:155-161.
  5. Popkirov S, Kowalski T, Schlegel U, Skodda S. Immunoglobulin-G4-related hypertrophic pachymeningitis with antineutrophil cytoplasmatic antibodies effectively treated with rituximab. J Clin Neurosci 2015; 22:1038-1040. 
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