General description

Hypertrophic pachymeningitis is a recognized central nervous system complication of rheumatoid arthritis. Inflammation of the leptomeninges and arachnoid membranes can lead to meningitis and granulomatous lesions with acute involvement. Patients may present with hemiplegia, sensory disturbances, and impaired consciousness.

Radiographic features

In addition to Hypertrophic pachymeningitis, MRI shows FLAIR hyperintensity and contrast enhancement of the leptomeninges. The adjacent subarachnoid space also demonstrates hyperintensity on FLAIR.