Abstract
Hypertrophic pachymeningitis is an inflammatory fibrous process which involves the dura mater, especially the cerebellar tentorium. Idiopathic hypertrophic cranial pachymeningitis is essentially a diagnosis of exclusion. The authors describe three patients with idiopathic hypertrophic cranial pachymeningitis who presented a variety of clinical features. Imaging studies revealed diffuse thickening of the dura mater. The first patient presented with headache and cranial nerve palsies. MRI revealed enhancing hypertrophic dura mater over the subdural effusion. The second patient complained of headache and nausea. CT demonstrated hydrocephalus and thickening of the falx and cerebellar tentorium. Imaging studies of the third patient showed a mass lesion mimicking meningioma en plaque. Etiology of the pachymeningitis is not clarified in any of these three cases, which are therefore diagnosed as idiopathic hypertrophic cranial pachymeningitis.
