Idiopathic Hypertrophic Cranial Pachymeningitis Presenting with Lower Cranial Nerve Palsy Mimicking Meningioma

ABSTRACT

We report a patient with idiopathic hypertrophic cranial pachymeningitis (IHCP) who presented with headache, tinnitus, hearing loss, dizziness and tongue atrophy. She initially was misdiagnosed as having an en plaque meningioma involving the posterior fossa and foramen magnum on the basis of brain MRI findings. A meningeal biopsy excluded meningioma and a diagnosis of IHCP was made. After immune modulating treatment, the patient's symptoms gradually improved. Our case shows IHCP should be included in the differential diagnosis of meningeal mass.