Aloni Eyal, Arow Majd, Harstein Moris, Almer Zina, Sholohov Galina
Department of Ophthalmology, Barzilai University Medical Center, Israel.
Department of Ophthalmology, Assaf Harofeh Medical Center, Israel.
Harefuah. 2019 Feb;158(2):96-100.
Fulminant intracranial hypertension is a rare, acute presentation of idiopathic intracranial hypertension with rapid and devastating visual loss that can lead to blindness. As vision deteriorates quickly and often irreversibly, prevention of further visual loss requires emergent treatment to decrease intracranial pressure. The case presented is that of an 18 years old male with new symptoms of headaches and visual obscurations that had rapid progressive visual loss with findings of severe bilateral swollen discs. Brain MRI and MRV ruled out intracranial mass and cerebral venous thrombosis. A lumbar puncture confirmed highly increased ICP. Due to the fulminant clinical presentation, he underwent an urgent fenestration of both optic nerves with improvement of vision in both eyes. The patient's clinical scenario accentuates the importance of prompt recognition of this rare disorder and the need for immediate surgical intervention to prevent further visual loss and blindness.
暴发性颅内高压是特发性颅内高压的一种罕见急性表现，伴有迅速且严重的视力丧失，可导致失明。由于视力迅速恶化且往往不可逆转，预防进一步的视力丧失需要紧急治疗以降低颅内压。本文介绍的病例是一名18岁男性，出现头痛和视力模糊的新症状，视力迅速进行性丧失，伴有双侧严重视盘肿胀。脑部MRI和MRV排除了颅内占位和脑静脉血栓形成。腰椎穿刺证实颅内压显著升高。由于临床表现暴发性，他接受了紧急双侧视神经开窗术，双眼视力均有改善。患者的临床情况突出了及时识别这种罕见疾病的重要性以及立即进行手术干预以防止进一步视力丧失和失明的必要性。
