Hypertrophic Intracranial Pachymeningitis of a Tuberculosis Etiology: Case Rreport and Systematic Review of the Literature

Background: Intracranial pachymeningitis is a rare neurological condition and tuberculosis as its etiology is uncommon. In the literature, little information is known about the epidemiological profile, clinical presentation, diagnosis, management, and outcome of patients with pachymeningitis of tuberculous origin.
Methods: The authors present a case of tuberculosis intracranial pachymeningitis with a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant studies (up to June 2021) that reported patients with intracranial pachymeningitis of tuberculosis origin, were identified from the Google Scholar, PubMed, and Cochrane Library databases.
Results: This systematic review identified 19 patients of whom 11 were male and 8 were female. The mean value of age was 39.42 (Std. Deviation 14.54) years. Eleven patients had intracranial hypertension and hemiparesis while five presented with headache and blurred vision at admission. Surgery was performed in 18 patients. The presence of mycobacterium tuberculosis was not confirmed in one patient treated successfully with the anti-tuberculosis drugs. Furthermore, 18 out of the 19 patients reported improved outcomes, only 1 patient died due to delay seeking health care, thus, delay management.
Conclusion: Tuberculosis as etiology of intracranial pachymeningitis need to be searched in all patient presenting with this condition whether he is coming from a tuberculous endemic region or not.

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The authors declare no conflict of interest.

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The datasets used in this study are openly available at [repository link] and the source code is available on GitHub at [GitHub link].

This work did not receive any external funding.