Idiopathic intracranial pachymeningitis in a patient on CAPD

AbstractWe report a very rare condition of idiopathic intracranial pachymeningitis (IIP) in a 66-year-old lady who had been on continuous ambulatory peritoneal dialysis (CAPD) for 3 years. Of the less than 20 reported cases of IIP in literature, this is a second case of IIP occurring in uremic patients. The presentation in this lady was drowsiness, hallucination and an abnormal afferent pupillary reflex. The diagnosis was made by magnetic resonance (MR) imaging which showed diffusely thickened meninges, and meningeal biopsy showed chronic fibrotic change, with scattered mononuclear cells without significant inflammatory element. There was transient symptomatic improvement with steroid therapy but she deteriorated 6 months later and finally died 15 months after steroid therapy