Exploring Hypertrophic Pachymeningitis: A Report of Two Cases

Hypertrophic pachymeningitis is a rare and complex disease with various aetiologies characterized by inflammation and thickening of the cranial or spinal duramater or both. The diagnosis is to be suspected on clinical, laboratory, radiological examination and can be confirmed on Dural biopsy. For the management, early diagnosis through relevant clinical history and radiological investigation is required. This case series highlight hypertrophic meningitis as a rare cause of altered mental status and the importance of a comprehensive medical history and examination for the diagnosis of such disease as early diagnosis of such cases and early initiation of the therapy can lead to better outcome. Steroid therapy is given as the first line of management but if patient does not respond to steroid therapy, it may progress to permanent neurological deterioration.