Abstract
Hypertrophic pachymeningitis (HP) is a chronic progressive diffuse inflammatory fibrosis of the dura mater, leading to its enlargement and subsequent nervous system sequelae. We report a case of a 71-year-old man who was diagnosed as hypertrophic cranial pachymeningitis. His initial symptoms were double vision and headache, which were followed by various cranial nerve symptoms such as ptosis, dysphagia, and hoarseness, as well as the headache. In the early stages, the headache was severe and resembled a cluster headache. However, it became continuous and dull at later stages. T1-weighted magnetic resonance imaging using gadolinium contrast was useful for diagnosis of the thickening of dura mater. Steroid therapy was started, and the cranial nerve symptoms improved immediately.
