Idiopathic hypertrophic chronic pachymeningitis. Contribution of two new cases and literature review

The idiopathic hypertrophic chronic pachymeningitis (IHCP) is a rare disorder characterized by chronic inflammation of the dura mater that there can be associated with resulting neurological deficits from the compression of underlying structures. The etiology of the pathologic process is uncertain and for its diagnosis it is necessary to rule out infectious pathology, diseases of the immune system and other processes, together with the pathological confirmation of the existence of a steril and chronic inflammatory infiltrate of the dura mater, and without evidence of vasculitic sings or malignancy. The IHCP is an infrequent entity. Through Medline last 35 years review we have found 58 cases of IHCP, of which in 43 the affectation was located at intracranial level, being this the most frequent localization, followed by 11 cases where the affectation was located at spinal level and 4 at craniospinal level. We present two clinical cases of IHCP of spinal localization, one at dorsal level and another one at the lumbar level seen in our institution, and we review the clinical manifestations, diagnostic methods, and therapeutic attitude used in the cases found in the literature.