A Case of Hypertrophic Pachymeningitis Caused by Tuberculosis

Hypertrophic pachymeningitis is a rare disorder, with idiopathic, tuberculosis, syphilis and sarcoidosis being the most commonly considered etiology. We experienced a case of hypertrophic pachymeningitis caused by tuberculosis a 34-year old female. She had complained of consistent headache and diplopia for 20 days. The characteristic finding on magnetic resonance imaging was marked thickening of the unilateral cerebellar tentorium with gadolinium-DTPA enhancement. There was no significant changes on adjacent brain parenchyma. Histologic investigation of the left cerebellar tentorium disclosed chronic granulomatous inflammation with central caseous necrosis. The patient was successfully managed with anti-tuberculosis drugs.