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Idiopathic hypertrophic cranial pachymeningitis manifested by transient ischemic attack.
Yuhua Fan1, Songjie Liao, Jian Yu
1Department of Neurology and Stroke Centre, the 1st Affiliated Hospital, Sun Yat-Sen University, Guangzhou, PR China.
Summary
Idiopathic hypertrophic cranial pachymeningitis (IHCP) can manifest as transient ischemic attacks (TIAs). Pulse corticosteroid therapy proved effective in treating this rare condition presenting with TIA symptoms.
Area of Science:
- Neurology
- Pathology
Background:
- Idiopathic hypertrophic cranial pachymeningitis (IHCP) is a rare dural thickening disorder.
- Typical symptoms include headache, cranial nerve issues, ataxia, and seizures.
- Transient ischemic attacks (TIAs) are not commonly reported as primary IHCP manifestations.
Observation:
- A 33-year-old male presented with recurrent left hemiparesis, suggestive of TIAs.
- Cranial CT and MRI revealed dural thickening along the falx and tentorium.
- Histopathology confirmed diffuse dural thickening with collagen, inflammation, and fibrinoid necrosis.
Findings:
- IHCP was diagnosed based on clinical and imaging findings.
- Initial treatments (antiplatelet, heparin, herbs) were ineffective for TIA episodes.
- Pulse corticosteroid therapy demonstrated significant efficacy in managing the patient's symptoms.
Implications:
- Recurrent TIAs can be a primary clinical presentation of IHCP.
- Pulse corticosteroid therapy is a viable and effective treatment for IHCP presenting with TIAs.
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