J Korean Child Neurol Soc.  2012 Dec;20(4):256-260.

Headache with Dural Thickening on MRI as an Initial Presentation of Leukemia: A Case Report

• Yoo SS
• Suh ES

Abstract

Headache can be divided into two categories: primary and secondary. Secondary headaches are associated with central nervous system or other pathology, and the underlying cause of a secondary headache can lead to death. For that reason, a thorough history and examination is key to determining the cause of headache. Other investigations including neuroimaging studies should be strongly considered in children with a history worrisome for intracranial pathology or an abnormal neurologic examination. We present a case of headache with diffuse hypertrophy of the dura mater due to lymphomatous dural infiltration. MRI revealed diffusely enhancing dural thickening. Biopsy of the dura mater found precursor B-cell lymphoblastic lymphoma. The patient was diagnosed with acute lymphoblastic leukemia and the headache was the initial presentation of acute leukemia. In this case, the rapid expansion of the dura mater resulted in elevation of intracranial pressure and caused an acute onset, progressive headache.

Keyword

Headache; Meninges; Leukemia

MeSH Terms

Biopsy
Central Nervous System
Child
Dura Mater
Headache
Humans
Hypertrophy
Intracranial Pressure
Leukemia
Meninges
Neuroimaging
Neurologic Examination
Precursor B-Cell Lymphoblastic Leukemia-Lymphoma
Precursor Cell Lymphoblastic Leukemia-Lymphoma