Pachymeningitis presenting feature of posterior sinus infection.

Pachymeningitis may be the presenting symptom of an adjacent paranasal sinus or ear infection. Inflammatory disease of the posterior sinuses (sphenoid and posterior ethmoid cells) may not clinically be apparent and might be overlooked. We report three patients presenting with symptoms and signs of pachymeningitis due to posterior sinus infection. Surgical and/or medical treatment of the local disease results in resolution of the pachymeningitis.