Idiopathic Intracranial Hypertension: Description of an Atypical Case

Abstract

Siri Laura, Gaiero Alberto, Maritano Lorenza, Vaira Massimo, Anselmo Marco, Polvicino Mario, Calia Stefano, Gaggero Roberto, Cohen Amnon

Background: When dealing with severe and worsening headache with oculomotor dysfunction, it is necessary to take into account the possibility of idiopathic intracranial hypertension (IHH), though it is a rare condition. We present an atypical case of IHH in a 4-year-old patient with no apparent risk factors.

Methods: IHH was diagnosed by exclusion, by ocular fundus examination, liquor cerebrospinalis examination, anatomical cerebral magnetic resonance imaging (MRI) and MR angiography (MRA). At the onset of symptoms, the patient was treated with a diuretic and steroid therapy.

Results: After one year of medical therapy, we observed headache recurrence with positive ophalmological assessment and positive cerebral MRI. Medical treatment was deemed ineffective and it was necessary for the patient to undergo surgical intervention.

Conclusion: We report a case of severe and chronic headache with oculomotor dysfunction in a young, pre-adolescent patient. This case is atypical because of the young age of the patient, and it being refractory to medical therapy. This case confirms that when dealing with severe headache in young patients, it is necessary to take into account any rare cause of symptomatic headache.

PDF