Hypertrophic pachymeningitis: management
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Hypertrophic pachymeningitis: management. This shows dural enhancement. It may also show the ‘Eiffel-by-night’ sign. Fully referenced neurology checklist.
Magnetic resonance imaging (MRI)
- This shows dural enhancement
- It may also show the ‘Eiffel-by-night’ sign
Cerebrospinal fluid (CSF) analysis: features
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Dural biopsy
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Treatment
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References
- Kupersmith, MJ, Martin V, Heller G, Shah A, Mitnick HJ. Idiopathic hypertrophic pachymeningitis. Neurology 2004; 62:686-694.
- Thomas B, Thamburaj K, Kesavadas C. 'Eiffel-by-night': a new MR sign demonstrating reactivation in idiopathic hypertrophic pachymeningitis. Neuroradiol J 2007; 20:194-195.
- Brescovit DO, Lucato LT, Castro LHM, Marie SKN, Silva GD. "Eiffel-by-night" sign in hypertrophic pachymeningitis: clinical and radiological correlates. Clin Neurol Neurosurg 2026; 262:109291.
- Maher M, Zanazzi G, Faust P, Nickerson K, T Wong T. IgG4-related hypertrophic pachymeningitis of the spine with MPO-ANCA seropositivity. Clin Imaging 2017; 46:108-112.
- Jang Y, Lee ST, Jung KH, Chu K, Lee SK. Rituximab treatment for idiopathic hypertrophic pachymeningitis. J Clin Neurol 2017; 13:155-161.
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