An Unusual Case of Headache in a Child: Idiopathic Intracranial Hypertension with Diagnostic Challenge

Autor: Youssef Ali M Alqahtani, Mohammed Fahad Aljabri, Mohammed Ahmed Mohammed Oshi, Naglaa M Kamal, Waleed Elhaj, Sara A Abosabie, Salma AS Abosabie
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Clinical Medicine Insights: Case Reports, Vol 16 (2023)
Druh dokumentu: article
ISSN: 1179-5476
11795476
DOI: 10.1177/11795476231158509
Popis: Introduction: In children, idiopathic intracranial hypertension (IIH) is relatively uncommon. It is characterized by an increase in intracranial pressure, in the absence of evidence of underlying brain disease, structural abnormalities, hydrocephalus, or abnormal meningeal improvement. However, very rarely it can occur without papilledema, even though it is the most recognizable clinical sign. Due to this, a delay in diagnosis can lead to severe visual impairments. Case presentation: We describe a patient with a chronic headache but no papilledema. His neurological and systemic examinations were otherwise unremarkable. A lumbar puncture revealed a high opening pressure of 450 mmH 2 O and normal cerebrospinal fluid (CSF) parameters. Magnetic resonance imaging of the brain revealed only tortuous optic nerves, no parenchymal lesions, and no evidence of venous sinus thrombosis. He required acetazolamide treatment. Our patient’s symptoms improved significantly in 2 months with medical treatment, weight loss, and exercise, with no development of papilledema. Conclusion: There is a wide range of clinical manifestations of IIH, making it difficult to decide when to begin treatment.
Databáze: Directory of Open Access Journals