Combined Hypertrophic Pachymeningitis and Cerebral Venous Thrombosis in a Case of Granulomatosis with Polyangiitis

Tadahiro Kuribayashi, Yasuhiro Manabe, Shunya Fujiwara, Yoshio Omote, Hisashi Narai, Koji Abe

Research output: Contribution to journalArticle


We report a rare case of hypertrophic pachymeningitis (HP) and cerebral venous thrombosis associated with proteinase-3-antineutrophil cytoplasmic antibody (PR3-ANCA)-positive granulomatosis with polyangiitis (GPA). A 58-year-old male developed left headache after exudative otitis media. The laboratory data were positive for PR3-ANCA. Brain magnetic resonance imaging revealed bilateral paranasal sinusitis, left frontal lobe edema, and a thick dura mater with abnormal enhancement in the frontotemporal lobe. Magnetic resonance venography detected stenosis of the superior sagittal sinus. The patient was successfully treated with glucocorticoid, cyclophosphamide, and apixaban. Contrast neuroimaging should be performed for patients who present with unexplained headache, especially with middle ear and paranasal inflammation. These symptoms should be considered as GPA-related HP and cerebral venous thrombosis.

Original languageEnglish
Pages (from-to)252-255
Number of pages4
JournalCase Reports in Neurology
Issue number2
Publication statusPublished - May 1 2019



  • Antineutrophil cytoplasmic antibody
  • Central nervous system
  • Cerebral venous thrombosis
  • Granulomatosis with polyangiitis
  • Hypertrophic pachymeningitis

ASJC Scopus subject areas

  • Clinical Neurology

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