Pachymeningeal enhancement—a comprehensive review of literature

Antony, Joyce, Hacking, Craig and Jeffree, Rosalind L. (2015) Pachymeningeal enhancement—a comprehensive review of literature. Neurosurgical Review, 38 4: 649-659. doi:10.1007/s10143-015-0646-y


Author Antony, Joyce
Hacking, Craig
Jeffree, Rosalind L.
Title Pachymeningeal enhancement—a comprehensive review of literature
Journal name Neurosurgical Review   Check publisher's open access policy
ISSN 1437-2320
0344-5607
Publication date 2015-08-13
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1007/s10143-015-0646-y
Open Access Status Not Open Access
Volume 38
Issue 4
Start page 649
End page 659
Total pages 11
Place of publication Heidelberg, Germany
Publisher Springer
Collection year 2016
Language eng
Abstract Pachymeningeal enhancement, synonymous with dural enhancement, is a radiological feature best appreciated on a contrast-enhanced magnetic resonance imaging (MRI). The vasculature of the dura mater is permeable, facilitating avid uptake of contrast agent and subsequent enhancement. Thin, discontinuous enhancement can be normal, seen in half the normal population. In patients complaining of postural headaches worse on sitting, gadolinium-enhanced MRI findings of diffuse pachymeningeal enhancement is highly suggestive of benign intracranial hypotension. In these cases, the process of pachymeningeal enhancement is explained by the Monro–Kellie doctrine as compensatory volume changes by vasocongestion and interstitial oedema of the dura mater due to decreased cerebrospinal fluid (CSF) pressure. Focal and diffuse pachymeningeal enhancement can also be attributed to infectious or inflammatory, neoplastic and iatrogenic aetiologies. Correction of the underlying pathology often results in spontaneous resolution of the pachymeningeal enhancement. There have also been reports of pachymeningeal enhancement associated with cerebral venous sinus thrombosis, temporal arteritis, baroreceptor reflex failure syndrome and arteriovenous fistulae.
Keyword Dural
Enhancement
MRI
Pachymeningeal
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2016 Collection
School of Medicine Publications
 
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