Visual loss from idiopathic intracranial pachymeningitis

Byron L. Lam, D. A. Barrett, J. S. Glaser, N. J. Schatz, H. H. Brown

Research output: Contribution to journalArticlepeer-review

50 Scopus citations


We report three patients with chronic headaches and optic neuropathy due to widespread meningeal thickening shown on enhanced MRI; all had biopsy- proven intracranial pachymeningitis (fibrosclerosis of the meninges). Two patients had bilateral optic neuropathy, elevated CSF protein, and polyclonal serum hypergammaglobulinemia. They developed temporal lobe cortical necrosis or sagittal sinus thrombosis, presumably due to compromised dural venous drainage from extensive meningeal fibrosis. The other patient had multiple cranial nerve palsies and unilateral optic neuropathy with normal CSF. Corticosteroid therapy improved visual function in all three patients, although all had persisting visual deficits. Gadolinium-enhanced MRI was essential in identifying meningeal inflammation and locating suitable biopsy sites.

Original languageEnglish (US)
Pages (from-to)694-698
Number of pages5
Issue number4
StatePublished - Apr 1994
Externally publishedYes

ASJC Scopus subject areas

  • Clinical Neurology


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