Hypertrophic cranial pachymeningitis is a rare chronic fibrosing inflammatory disease characterized by marked diffuse thickening of the cranial dura mater that causes progressive neurological deficits. Chronic headache and cranial neuropathy are the common clinical manifestations of patients with hypertrophic cranial pachymeningitis. Gadolinium enhanced T1WI, coronal sequence, reveals markedly thickened and enhancing falx and tentorium cerebelli. This is a 35yr old female with chronic headache.
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