Recurrent idiopathic hypertrophic pachymeningitis with chronic headache and cranial nerve involvement

Idiopathic hypertrophic pachymeningitis is a rare, fibrosing inflammatory disease that causes localized or diffuse thickening of the dura mater in the brain and/or spinal cord. It may be cranial, spinal, and/or craniospinal pachymeningitis depending on the place of involvement. In our case, a 34-year-old woman presented with sixth cranial nerve involvement and headache and was diagnosed with idiopathic hypertrophic pachymeningitis as a result of the exclusion of other causes and central nervous system imaging. Clinical and radiological follow-up occurred for 1 year, and treatment is presented.