WEGENERS GRANULOMATOSIS WITH DURAL INVOLVEMENT AS THE INITIAL CLINICAL MANIFESTATION

We treated a patient with an atypical presentation of Wegener's granul omatosis (WG) with dural involvement as the initial clinical manifesta tion. A 37-year-old man had a dural lesion without lower respiratory t ract or renal manifestations in the initial clinical course, His only initial symptom was headache, and at disease onset computed tomography (CT) and magnetic resonance imaging (MRI) of the head revealed bilate ral abnormal subdural masses, The diagnosis of WC was made based on th e results of needle biopsy of the nasal polyps and the finding of posi tive circulating antineutrophil cytoplasmic antibodies (c-ANCA). He ac hieved remission on daily prednisone and cyclophosphamide with the lat er addition of sulfamethoxazole-trimethoprim.