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Tuberculous cranial pachymeningitis.

Thurtell MJ, Keed AB, Yan M, Gottlieb T, Spies JM, Halmagyi GM

Department of Neurology, Royal Prince Alfred Hospital, NSW, Australia. matthewt@icn.usyd.edu.au

We describe two immunocompetent patients with tuberculous cranial pachymeningitis. Both patients underwent biopsy after focal dural thickening was identified on MRI. Histopathologic examination of tissue revealed necrotizing granulomatous inflammation. PCR for Mycobacterium tuberculosis DNA was negative on CSF but positive on tissue. Both patients responded to antituberculous therapy. Although uncommon as a cause of cranial pachymeningitis, tuberculosis should be considered, since it responds well to treatment.

Published 23 January 2007 in Neurology, 68(4): 298-300.
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