A case of cerebral venous thrombosis caused by idiopathic hypertrophic pachymeningitis

A case of cerebral venous thrombosis caused by idiopathic hypertrophic pachymeningitis Shunta Hashiguchi, M.D., Yuko Kawamoto, M.D., Yuji Johmura, M.D., Masahito Okada, M.D., Ph.D., and Fumiaki Tanaka, M.D., Ph.D. Department of Neurology, Saiseikai Yokohama-shi Nanbu Hospital Department of Neurology, Yokohama Minami Kyosai Hospital Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine A 41-year-old man presented with progressively deteriorating headache and behavioral disorder. Neurological examination showed slight cognitive decline and neck stiffness. Brain MRI demonstrated diffuse thickening of the dura mater. The etiology of the dural thickening was considered to be idiopathic because no infectious, autoimmune, or neoplastic disorders could be found. MR venography revealed occlusion of the superior sagittal and transverse sinuses. The diagnosis was cerebral venous sinus thrombosis due to idiopathic hypertrophic cranial pachymeningitis (IHPM). Subsequent treatment with corticosteroids and an anticoagulant led to full recovery. In a case of cerebral venous thrombosis with headache, it is required to examine the dural thickening and vice versa in a case of IHPM, an association of cerebral venous thrombosis should be considered.