The drilling in the brain can be a problem. The open biopsy involved removing a stamp sized piece of my skull just forward and above the L ear. No shaving of hair. I have a titanium plate below the skin now. You can still have MRI as titanium is not magnetic. I worked with a vestibular therapist on balance. A specialized Physical Therapist with a special room where the floors and walls actually move to test balance. You have a harness so you can't fall. She developed a special Epley maneuver for me. They do have upright MRI units for those who need them. I used a company called 2nd MD for a second opinion. They are online and review all your records. Very expensive. Also your available records might not be adequate. I now have 2 other neurologic problems Myasthenia Gravis and Churg Strauss Syndrome. Managing. Still have a pretty good life. No cause is known for the Pachymeningitis. There are several thousands of known cases. An Elephant is a Pachyderm meaning thick skin, Pachymeningitis means thick meninges. As a 100% service-disabled Viet Nam Veteran all my medical care is free. Fought with some great Aussie's in the Il Drang Valley. Never surrender.