Altinbas A, Hoogstede H A L F, Bakker S L M
Amphia Ziekenhuis, Molengracht 21, 489rg CK Breda.
Ned Tijdschr Geneeskd. 2005 Aug 20;149(34):1908-12.
A young, non-obese woman aged 24 years with normal blood pressure developed intracranial hypertension after the oral use of tetracycline. Neuro-ophthalmologic examination revealed severely reduced acuity, papilledema, and concentric impaired visual fields. She was treated with acetazolamide and recurrent lumbar punctures and recovered, but without improvement in either acuity or visual fields. Intracranial hypertension is a fairly rare disease characterised by increased intracranial pressure without structural abnormalities in the brain or hydrocephalus, and is termed idiopathic in the absence of an underlying cause. Tetracycline should be considered as a cause of intracranial hypertension if a patient complains of previously unknown headache a few days after its ingestion. Headache and the presence of bilateral papilledema, decreased visual acuity and visual-field defects are indications for urgent referral to a neurologist. Therapy consists of a combination of repetitive lumbar punctures and medication. Surgical interventions include lumboperitoneal shunting and optic nerve fenestration. Intracranial hypertension may lead to irreversible decreased visual acuity and visual-field defects resulting in disability.
一名24岁血压正常的年轻非肥胖女性在口服四环素后出现颅内高压。神经眼科检查显示视力严重下降、视乳头水肿和同心性视野缺损。她接受了乙酰唑胺治疗和反复腰椎穿刺，病情有所恢复，但视力和视野均未改善。颅内高压是一种相当罕见的疾病，其特征是颅内压升高，而脑部无结构异常或脑积水，在没有潜在病因的情况下被称为特发性颅内高压。如果患者在摄入四环素几天后抱怨出现此前未知的头痛，则应考虑四环素为颅内高压的病因。头痛以及双侧视乳头水肿、视力下降和视野缺损的出现是紧急转诊至神经科医生的指征。治疗包括反复腰椎穿刺和药物联合使用。手术干预措施包括腰大池腹腔分流术和视神经开窗术。颅内高压可能导致不可逆的视力下降和视野缺损，从而导致残疾。
