Pachymeningitis

• Published in: La revue de medecine interne Vol. 38; no. 9; pp. 585 - 591
• Main Authors: Fain, O, Mekinian, A
• Format: Journal Article
• Language: French
• Published: France 01.09.2017
• Subjects: Central Nervous System Infections - complications; Central Nervous System Infections - diagnosis; Central Nervous System Infections - epidemiology; Central Nervous System Neoplasms - complications; Central Nervous System Neoplasms - diagnosis; Central Nervous System Neoplasms - epidemiology; Diagnosis, Differential; Headache - diagnosis; Headache - etiology; Humans; Magnetic Resonance Imaging; Meningitis - classification; Meningitis - diagnosis; Meningitis - epidemiology; Meningitis - etiology; Vasculitis - complications; Vasculitis - diagnosis; Vasculitis - epidemiology; Sarcoïdose; IgG4-related disease; Tuberculosis; Pachymeningitis; Sarcoidosis; Pachyméningites; Maladie associée aux IgG4; Syphilis; Granulomatosis with polyangiitis; Tuberculose; Granulomatose avec polyangéite
• ISSN: 1768-3122
• DOI: 10.1016/j.revmed.2017.03.011

Pachymeningitis is a fibrosing and inflammatory process, which involves the dura mater. Some pachymeningitis are cranial and induce headaches and cranial nerve palsies. Others are spinal and responsible for nerve roots or spinal cord compression. MRI shows contrast enhancement thickening of the dura mater. Etiologies are infectious (syphilis, tuberculosis, etc.) or inflammatory (sarcoidosis, granulomatosis with polyangiitis, IgG4-related disease, idiopathic). Corticosteroids are the main treatment. The use of immunosuppressive drugs or rituximab is yet to be determined and probably adapted to each etiology.