# Idiopathic hypertrophic pachymeningitis (IHP) causing headache in a young female

## TL;DR

A young woman with a rare brain condition causing headaches and facial numbness was diagnosed with idiopathic hypertrophic pachymeningitis and improved with corticosteroid treatment.

## Contribution

This case highlights idiopathic hypertrophic pachymeningitis as a rare cause of headache in young adults and underscores the importance of comprehensive diagnostic evaluation.

## Key findings

- Neuroimaging revealed diffuse dura mater thickening consistent with hypertrophic pachymeningitis.
- Exclusion of infectious and autoimmune causes led to a diagnosis of idiopathic hypertrophic pachymeningitis.
- Corticosteroid treatment significantly improved the patient's symptoms.

## Abstract

Hypertrophic pachymeningitis (HP) is characterised by thickening of the cranial or spinal dura mater, and it encompasses idiopathic and secondary forms. Later is linked to infections, inflammatory conditions, and autoimmune disorders. This rare condition presents with a myriad of neurological manifestations, including headaches, cranial nerve palsies, and visual disturbances. A South-Asian woman in her mid-thirties presented with a three-month history of left-sided headache, double vision, and facial numbness. Neuroimaging revealed diffuse thickening of the dura mater, suggestive of hypertrophic pachymeningitis (HP). Diagnostic workup excluded infectious and autoimmune causes, categorising the condition as idiopathic. Treatment with corticosteroids led to significant improvement in her symptoms. HP is a rare cause of headache in young patients, and diagnosis relies on neuroimaging and CSF analysis, necessitating the exclusion of secondary causes through comprehensive evaluation. Treatment varies based on the underlying aetiology. Corticosteroids remain the first-line drug for idiopathic cases.

None declared