Idiopathic intracranial hypertension following childbirth: a case report and management strategies.

Autor: Ibrahim AA; Department of Neurology, Mogadishu Somalia Turkish Training and Research Hospital., Sheikh Hassan M; Department of Neurology, Mogadishu Somalia Turkish Training and Research Hospital.; Faculty of Medicine and Surgery, Mogadishu University, Somalia., Ahmed AA; Department of Ophthalmology, Mogadishu Somali Turkish Training and Research Hospital., Sidow NO; Department of Neurology, Mogadishu Somalia Turkish Training and Research Hospital., Farah Osman Hidig M; Department of Neurology, Mogadishu Somalia Turkish Training and Research Hospital., Kadiye MS; Department of Ophthalmology, Mogadishu Somali Turkish Training and Research Hospital., Adam BA; Department of Neurology, Mogadishu Somalia Turkish Training and Research Hospital.
Jazyk: angličtina
Zdroj: Annals of medicine and surgery (2012) [Ann Med Surg (Lond)] 2024 Sep 18; Vol. 86 (11), pp. 6784-6787. Date of Electronic Publication: 2024 Sep 18 (Print Publication: 2024).
DOI: 10.1097/MS9.0000000000002575
Abstrakt: Introduction: A postpartum headache, also known as pseudotumor cerebri, is defined as a headache and shoulder or neck pain that occur in the first 6 weeks following childbirth. Common causes of headaches during puerperium include pre-eclampsia, subarachnoid hemorrhage, cerebral venous thrombosis, meningitis, brain tumors, cerebrovascular diseases, and posterior reversible encephalopathy syndrome. Pseudotumor cerebri is an extremely rare cause of postpartum severe headache with visual disturbance with or without papilledema.
Case Presentation: Here, the authors present a 32-year-old postpartum female patient who presented with a severe headache and visual disturbance for 10 days. Neurological examination did not show any focal or lateralizing deficit. However, a fundus examination showed severe bilateral papilledema. A contrast-enhanced brain MRI did not reveal a space-occupying mass lesion. MRV excluded venous occlusion. A lumbar puncture demonstrated a high opening pressure of 75 cmH 2 O with a normal cell count and protein and glucose levels. The patient was diagnosed with idiopathic intracranial hypertension. After 8 weeks of treatment with diazomid and topiramate, the patient improved clinically, and her papilledema regressed.
Clinical Discussion: The occurrence of IIH is very rare among postpartum females. To our knowledge, very few cases of postpartum IIH have been reported in the medical literature. Although rare, patients with postpartum headache with visual disturbances should have a fundoscopic examination. The patient was diagnosed and managed in time, which led to significant clinical improvement and salvage of her vision.
Conclusion: As described in this case, idiopathic intracranial hypertension can cause severe headaches with and without visual disturbance during the postpartum period (despite being rare in this period), so it should be considered in the differential diagnosis.
Competing Interests: The authors declare no conflict of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this articles.
(Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze: MEDLINE
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