Tuberculous hypertrophic pachymeningitis involving the posterior fossa and high cervical region - Case report

Abstract

A 44-year-old female presented with a rare tuberculous hypertrophic pachymeningitis involving the posterior fossa and high cervical region manifesting as progressive multiple cranial nerve pareses and myelopathy developing over 6 months. Magnetic resonance imaging demonstrated the thickened dura mater and associated syrinx. Despite decompressive craniectomy and antituberculous treatment, she died of disseminated intravascular coagulation. Hypertrophic pachymeningitis is probably best treated by the most extensive excision of affected dura mater possible, unless medical treatment can be instituted for an identifiable underlying causative disease.