Short‐Lasting Unilateral Neuralgiform Headache With Autonomic Symptoms Syndrome as the Initial Manifestation of Idiopathic Hypertrophic Cranial Pachymeningitis

Abstract

This is the first report of 2 patients presenting with short-lasting unilateral neuralgiform headache with autonomic symptoms as the initial manifestation of idiopathic hypertrophic cranial pachymeningitis. They both had acute retro-orbital pain ipsilateral to the dural thickening on magnetic resonance imaging of brain, and one had transient miosis as an additional parasympathetic feature. Short-lasting unilateral neuralgiform headache with autonomic symptoms syndrome may be associated with secondary central nervous system pathology, and neuroimaging should be considered in all patients with trigeminal autonomic cephalalgia.

Idiopathic hypertrophic pachymeningitis mimicking hemicrania continua: An unusual clinical case

“…Among these, unruptured intracranial aneurysms, internal carotid artery dissection, non-metastatic and metastatic lung cancer, inflammatory orbital pseudotumor, nasopharyngeal carcinoma, intracranial tumors and HIV infection have been extensively reported. Furthermore, although several cases of trigeminal-autonomic cephalalgias related to meningeal disorders, such as viral meningitis or pachymeningitis, have been previously described (7), to the best of our knowledge, none of these presented with HC clinical features.…”

Short-lasting unilateral neuralgiform headache with autonomic symptoms associated with idiopathic hypertrophic pachymeningitis

“…One prior case report described two cases of SUNA associated with idiopathic HP, which makes the present case the third reported in the literature. 2 We provide a unique follow-up of 9 years, whereas the two previous cases were followed up for less than a year. From the 9 years of follow-up in our case, we can conclude with a high level of certainty that HP is the correct diagnosis, as the clinical course fits idiopathic HP and has provided no arguments for an alternative diagnosis.…”

“…Rarely, SUNA and other forms of TAC are secondary to intracranial lesions. 1,2 Here, we report a case of SUNA secondary to idiopathic hypertrophic pachymeningitis (HP).…”

Idiopathic hypertrophic cranial pachymeningitis: a rare but treatable cause of headache and facial pain

“…IHCP is a rare disease of unknown aetiology, characterised by diffuse or localised thickening of the dura mater and optionally associated with inflammation1 that recently has gained more attention probably because of the wider application of MRI 2 3. Clinical symptoms can include headache, facial pain, vision loss, cranial nerve palsy and cerebellar ataxia 1–3.…”