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A pachymeningitis as an unusual cause of headache in systemic lupuserythematosus

Thara Larbi, Saloua B’chir Hamzaoui, Maroua Mrouki, Amira Manamani, Amira Ouni, Kamel Bouslama, Skander M’rad

We report a case of systemic lupus erythematosus (SLE) complicated by hypertrophic pachymeningitis (HP) four year after the onset of SLE. A 25-year-old woman with a previous diagnosis of SLE was admitted for severe headaches and vomiting without signs of meningeal irritation or papilloedema on fundus examination. Brain magnetic resonance imaging showed diffuse thikening of the dura matter with hyperintense signal on fluidattenuated inversion recovery sequence and gadolinium contrast enhancement. There was no sinus thrombosis on MR venography. Both clinical symptoms and imaging findings improved after steroid therapy