Pachymeningopathy is a group of clinical and anatomical syndromes in various brain diseases, combining the general clinic of pachymening and epimening. Pachymeningopathy syndrome is characterized by symptoms of both pachymenigal and epimenigal forms of pachymenopathy: severe headache, nausea, vomiting, congestion in the fundus, and sometimes motor disturbances, which can be caused by vascular and even liquorodynamic disorders. These symptoms were described in Russian literature for the first time in 1973 by S.B. Mandelstam in the pathomorphological study of inflammatory changes in the meninges of the “empty space” and arterial vascular changes, accompanied by foci of ischemia and necrosis, hemorrhages and chronic hydrocephalus.