Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentPrognosis
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Prognosis
Pachymeningitisis a rare medical condition in which the outer layer of the brain or spinal cord, called the dura mater, thickens and becomes inflamed. Symptoms vary based on the location of the affected area of dura mater but can include headaches and face pain.
The dura mater is the tough, outermost layer of tissue surrounding the brain andspinal cord. It is one of the three layers that make up themeninges.
This article will cover pachymeningitis symptoms, causes, diagnosis, and treatment.
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Symptoms of pachymeningitis vary based on where the dura mater has thickened and the amount of pressure placed on the brain or spinal cord. In some cases, there are no symptoms at all.
Pachymeningitis symptoms can include:
ICP is a medical emergency. If you are experiencing symptoms of ICP—which can include headache, nausea, fatigue, and vision changes—call your healthcare provider immediately.
What causes pachymeningitis is not always clear. Experts speculate that it is an autoimmune response, the result of an infection, or the result of another condition. In some people, the true cause of pachymeningitis may never be found. This is called idiopathic hypertrophic meningitis.
The following three conditions are usually the cause:
Pachymeningitis may also be associated with other inflammatory diseases, such as rheumatoid arthritis and lupus.
The gold standard for diagnosing pachymeningitis is abiopsyof the dura mater. In this procedure, a sample of tissue is surgically removed for analysis in a lab. The biopsy test results can help determine the cause. This procedure is often used along with other forms of diagnostic testing, including:
To prevent damage to the brain and spinal cord, early diagnosis and treatment are necessary. Pachymeningitis is typically treated with asteroid medication(such asprednisone) andimmunosuppressive therapy.
Immunosuppressants used to treat pachymeningitis include:
Patient-specific treatment varies based on the underlying condition. For example, if it is discovered that an infection is causing pachymeningitis, treatment would be focused on relieving the infection.
The prognosis after diagnosis varies from person to person and is dependent upon the underlying cause of the pachymeningitis.
According to a 2018 study, approximately 30% of people who had idiopathic hypertrophic pachymeningitis continued to have symptoms after completing treatment.
Summary
Pachymeningitis is a rare condition that causes areas of a layer of tissue that surrounds the spinal cord and brain (dura mater) to thicken and become inflamed. This thickening can cause different symptoms based on its location. Some people may have vision changes, headaches, or hearing loss. Treatment is based on the underlying cause and generally involves medications and, in some cases, surgery.
A Word From Verywell
Any condition that puts pressure on the spinal cord or brain, including pachymeningitis, is very serious and can even be life-threatening. If you have vision changes, headaches, hearing loss, or other neurological symptoms, contact your healthcare provider immediately.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ahmadi-Simab K, Lamprecht P, Reuter M, Gross WL.Pachymeningitis in mixed connective tissue disease.Annals of the Rheumatic Diseases. 2005;64(11):1656-1657. doi:10.1136/ard.2004.035204National Institute of Health.Dura mater.Abrantes FF, Moraes MPM de, Rezende Filho FM, Pedroso JL, Barsottini OGP.A clinical approach to hypertrophic pachymeningitis.Arq Neuro-Psiquiatr. 2020;78:797-804. doi:10.1590/0004-282X20200073Johns Hopkins Medicine.Increased intracranial pressure (ICP) headache.Karthik SN, Bhanu K, Velayutham S, Jawahar M.Hypertrophic pachymeningitis.Ann Indian Acad Neurol. 2011;14(3):203-204. doi:10.4103/0972-2327.85896National Institute of Neurological Disorders and Stroke.Neurosarcoidosis.Johns Hopkins Medicine.Granulomatosis with polyangiitis.Al-Khalili OM, Erickson AR.Igg-4 related disease: an introduction.Mo Med. 2018;115(3):253-256.Johns Hopkins Medicine.Computed tomography (CT) scan.Johns Hopkins Medicine.Magnetic resonance imaging (MRI).Mekinian A, Maisonobe L, Boukari L, et al.Characteristics, outcome and treatments with cranial pachymeningitis: A multicenter French retrospective study of 60 patients.Medicine. 2018;97(30):e11413. doi:10.1097/MD.0000000000011413National Organization of Rare Disorders.Idiopathic hypertrophic pachymeningitis.Huang Y, Chen J, Gui L.A case of idiopathic hypertrophic pachymeningitis presenting with chronic headache and multiple cranial nerve palsies.Medicine (Baltimore). 2017;96(29):e7549. doi:10.1097/MD.0000000000007549a
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ahmadi-Simab K, Lamprecht P, Reuter M, Gross WL.Pachymeningitis in mixed connective tissue disease.Annals of the Rheumatic Diseases. 2005;64(11):1656-1657. doi:10.1136/ard.2004.035204National Institute of Health.Dura mater.Abrantes FF, Moraes MPM de, Rezende Filho FM, Pedroso JL, Barsottini OGP.A clinical approach to hypertrophic pachymeningitis.Arq Neuro-Psiquiatr. 2020;78:797-804. doi:10.1590/0004-282X20200073Johns Hopkins Medicine.Increased intracranial pressure (ICP) headache.Karthik SN, Bhanu K, Velayutham S, Jawahar M.Hypertrophic pachymeningitis.Ann Indian Acad Neurol. 2011;14(3):203-204. doi:10.4103/0972-2327.85896National Institute of Neurological Disorders and Stroke.Neurosarcoidosis.Johns Hopkins Medicine.Granulomatosis with polyangiitis.Al-Khalili OM, Erickson AR.Igg-4 related disease: an introduction.Mo Med. 2018;115(3):253-256.Johns Hopkins Medicine.Computed tomography (CT) scan.Johns Hopkins Medicine.Magnetic resonance imaging (MRI).Mekinian A, Maisonobe L, Boukari L, et al.Characteristics, outcome and treatments with cranial pachymeningitis: A multicenter French retrospective study of 60 patients.Medicine. 2018;97(30):e11413. doi:10.1097/MD.0000000000011413National Organization of Rare Disorders.Idiopathic hypertrophic pachymeningitis.Huang Y, Chen J, Gui L.A case of idiopathic hypertrophic pachymeningitis presenting with chronic headache and multiple cranial nerve palsies.Medicine (Baltimore). 2017;96(29):e7549. doi:10.1097/MD.0000000000007549a
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ahmadi-Simab K, Lamprecht P, Reuter M, Gross WL.Pachymeningitis in mixed connective tissue disease.Annals of the Rheumatic Diseases. 2005;64(11):1656-1657. doi:10.1136/ard.2004.035204National Institute of Health.Dura mater.Abrantes FF, Moraes MPM de, Rezende Filho FM, Pedroso JL, Barsottini OGP.A clinical approach to hypertrophic pachymeningitis.Arq Neuro-Psiquiatr. 2020;78:797-804. doi:10.1590/0004-282X20200073Johns Hopkins Medicine.Increased intracranial pressure (ICP) headache.Karthik SN, Bhanu K, Velayutham S, Jawahar M.Hypertrophic pachymeningitis.Ann Indian Acad Neurol. 2011;14(3):203-204. doi:10.4103/0972-2327.85896National Institute of Neurological Disorders and Stroke.Neurosarcoidosis.Johns Hopkins Medicine.Granulomatosis with polyangiitis.Al-Khalili OM, Erickson AR.Igg-4 related disease: an introduction.Mo Med. 2018;115(3):253-256.Johns Hopkins Medicine.Computed tomography (CT) scan.Johns Hopkins Medicine.Magnetic resonance imaging (MRI).Mekinian A, Maisonobe L, Boukari L, et al.Characteristics, outcome and treatments with cranial pachymeningitis: A multicenter French retrospective study of 60 patients.Medicine. 2018;97(30):e11413. doi:10.1097/MD.0000000000011413National Organization of Rare Disorders.Idiopathic hypertrophic pachymeningitis.Huang Y, Chen J, Gui L.A case of idiopathic hypertrophic pachymeningitis presenting with chronic headache and multiple cranial nerve palsies.Medicine (Baltimore). 2017;96(29):e7549. doi:10.1097/MD.0000000000007549a
Ahmadi-Simab K, Lamprecht P, Reuter M, Gross WL.Pachymeningitis in mixed connective tissue disease.Annals of the Rheumatic Diseases. 2005;64(11):1656-1657. doi:10.1136/ard.2004.035204
National Institute of Health.Dura mater.
Abrantes FF, Moraes MPM de, Rezende Filho FM, Pedroso JL, Barsottini OGP.A clinical approach to hypertrophic pachymeningitis.Arq Neuro-Psiquiatr. 2020;78:797-804. doi:10.1590/0004-282X20200073
Johns Hopkins Medicine.Increased intracranial pressure (ICP) headache.
Karthik SN, Bhanu K, Velayutham S, Jawahar M.Hypertrophic pachymeningitis.Ann Indian Acad Neurol. 2011;14(3):203-204. doi:10.4103/0972-2327.85896
National Institute of Neurological Disorders and Stroke.Neurosarcoidosis.
Johns Hopkins Medicine.Granulomatosis with polyangiitis.
Al-Khalili OM, Erickson AR.Igg-4 related disease: an introduction.Mo Med. 2018;115(3):253-256.
Johns Hopkins Medicine.Computed tomography (CT) scan.
Johns Hopkins Medicine.Magnetic resonance imaging (MRI).
Mekinian A, Maisonobe L, Boukari L, et al.Characteristics, outcome and treatments with cranial pachymeningitis: A multicenter French retrospective study of 60 patients.Medicine. 2018;97(30):e11413. doi:10.1097/MD.0000000000011413
National Organization of Rare Disorders.Idiopathic hypertrophic pachymeningitis.
Huang Y, Chen J, Gui L.A case of idiopathic hypertrophic pachymeningitis presenting with chronic headache and multiple cranial nerve palsies.Medicine (Baltimore). 2017;96(29):e7549. doi:10.1097/MD.0000000000007549a
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