A case of hypertrophic cranial pachymeningitis with unusual findings of magnetic resonance imaging

Abstract

The case is a 53-year-old man with hypertrophic cranial pachymeningitis of the falx that showed interesting MR images. The patient was originally referred to our institute due to uncontrollable generalized seizure at the age of 51 years. MR images revealed a thickening falx with gadolinium (Gd) enhancement and an intra-axial abnormal Gd-enhanced lesion in the frontal lobe. These 2 abnormal enhanced lesions were not connected to each other on MR images. Bifrontal craniotomy with total resection was performed. The results of histopathological examination revealed chronic inflammatory change and no neoplastic findings. The patient has not experienced any seizures after surgery. Discrimination of pachymeningitis from neoplastic disease and particularly from malignant disease was important for appropriate treatments in this case.