Recently, a 35-year-old female patient with severe headache came to the Department of Encephalopathy of the District Hospital of Traditional Chinese Medicine and found Dr. Zhu Kaiyun, chief physician of the Department of Internal Medicine and Director of the Department of Encephalopathy of the hospital. It is understood that the patient often felt headache on the right side since July 2010, and often started to have throbbing pain in the right frontotemporal region at 5 or 6 pm every day, which lasted until the next morning, and she often had to drink alcohol before she could sleep at night, and her symptoms were repeated. He went to the hospital for a head CT and was diagnosed with sinusitis. The doctor treated the patient according to the treatment for sinusitis, and the head pain stopped after about a week. However, a few months later, the patient found that she easily experienced throbbing pain in the right frontal-temporal region when she was depressed, and the symptoms were relieved when she was in a good mood. In the past 7 to 8 months, the headache had become persistent, and she had been to several major hospitals in Guangzhou for treatment and had CT and MRI examinations of her head, but no special findings were found. In order to stop the pain, the patient needed to take headache san and ibuprofen, and had to take painkillers twice a day to relieve the pain. Over time, the pain level increased and the painkillers became ineffective in the past 1 week, and the headache seriously affected the patient’s sleep and appetite. Three days before coming to the hospital, the patient had to go to the local town hospital to get a painkilling injection because of the unbearable headache, but the painkilling effect of the injection only lasted for 2 hours, and he felt the headache again soon after returning home, and the headache also caused vomiting. The pain was so severe that the patient had the idea of light-heartedness. Later, through a friend’s introduction, the patient found Director Zhu Kaiyun. Zhu Kaiyun found that the patient was mentally ill, but the neurological examination did not reveal any positive signs. After a detailed understanding of the patient’s medical history and judging from experience, Kaiyun Zhu concluded that the patient’s headache should be a secondary headache, rather than a general primary headache. Because the patient had previously undergone CT and MRI scan of the head in other hospitals, the results did not find the cause of the headache, so he considered that it might be hypertrophic duralgia. Considering the severity of the headache and the complexity of the etiology, Kaiyun Zhu suggested that the patient be hospitalized. After admission, Kaiyun Zhu performed MRI scan and enhanced examination of the patient’s head, and the diagnostic results initially confirmed Kaiyun Zhu’s judgment. The next day, Kaiyun Zhu performed another lumbar puncture examination. After examination and analysis, Kaiyun Zhu diagnosed the patient with idiopathic hypertrophic dural meningitis. After determining the cause, Kaiyun Zhu provided the patient with targeted treatment, and the patient’s headache symptoms soon disappeared. After nine days of hospitalization, the patient recovered and was discharged. The key test to diagnose hypertrophic duralgia is an enhanced CT or MRI scan of the head, which can confirm the diagnosis if the dura is found to be reinforced, said Kaiyun Zhu. But generally speaking, if there are no special findings on CT or MRI plain scan of the head, doctors will not consider doing an enhancement scan, which is why the patient in this case was not diagnosed in time. The cause of idiopathic hypertrophic duralgia remains unclear and may be related to abnormalities in the body’s autoimmune function; secondary hypertrophic duralgia may be caused by tumor metastasis, chronic otitis media, cerebral tuberculosis, parasitic infection, etc., said Kaiyun Zhu. Overall, idiopathic hypertrophic duralgia is still relatively uncommon, but the incidence is higher in Easterners than in Westerners, and higher in women than in men. The most common symptom is headache, followed by damage to the cranial nerves. Because of its specificity, it is also difficult for patients to carry out effective prevention in ordinary life. However, Zhu Kaiyun also reminded the public that although the cause of the disease is difficult to determine, there are still many triggers in life. Like the patient in the case, long-term emotional depression and anxiety may be one of the triggers for the onset of the disease, because the headache will be aggravated when she is in a bad mood, so in order to avoid the disease, the public should maintain a good and positive attitude in life. Finally, we would like to remind people that if they have persistent headache or headache of unknown cause, they should go to the hospital in time, and if the treatment is not effective, they should seek treatment from headache treatment specialists to avoid delaying the diagnosis and treatment of the disease.