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Hypertrophic pachymeningitis is a rare disorder that characterized by chronic, inflammatory thickening of the dura.[1,2,4] This thickening can be ocalized or diffused. This condition can be divided based on its location, to cranial hypertrophic pachymeningitis and spinal hypertrophic pachymeningitis. 3 There are several known causes for hypertrophic pachymeningitis, including some infectious, autoimmune disorders, inflammatory disorders and neoplasms.3 Nevertheless, in some cases the etiology is unknown thus it called idiopathic hypertrophic pachymeningitis.1

Signs and symptoms
most of the clinical presentations are neurological. They can be affected by the location of the hypertrophic pachymeningitis. The main cliniacal features at presentation are headache, fever, loss of vision, diplopia, papilledema, cranial nerve involvement, ataxia, and more rarely seizures. 1,3