Department of General Practice and Emergency Medicine, Patan Academy of Health Sciences, Lagankhel, Lalitpur, Nepal.
Department of General Medicine, Nobel Hospital, Sinamangal, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2021 Feb 28;59(234):197-199. doi: 10.31729/jnma.5176.
Idiopathic Intracranial Hypertension is a rare occurrence in young, physically fit male and a diagnosis of exclusion among most patients presenting with signs and symptoms of raised intracranial pressure. Here we describe a case of a young male in the ideal weight range with no previous exposure to offending chemicals presented with a history of headache, obscuration of vision, and photopsia. On examination, there were no positive neurological findings. Increased opening pressure was found on the lumbar puncture. Ophthalmological examination revealed bilateral papilledema. Humphrey’s Visual field test showed peripheral field loss. Magnetic resonance imaging scan of the brain and orbits were normal. The patient was diagnosed and managed in primary care setting after neurosurgical consultation. Though rare, we should suspect idiopathic intracranial hypertension in ideal body weighted male if the headache is persistent after other causes of headache have been ruled out.
特发性颅内高压在年轻、身体健康的男性中较为罕见,且大多数出现颅内压升高体征和症状的患者都需要经过排除诊断才能确诊。本文描述了一位年轻男性的病例,他的体重处于理想范围内,且无接触过有害物质的既往史,主要表现为头痛、视力模糊和闪光幻觉。体格检查未见阳性神经系统发现。腰椎穿刺发现颅内压升高。眼科检查显示双侧视盘水肿。Humphrey 视野检查显示周边视野缺失。头颅和眼眶磁共振成像扫描正常。经神经外科会诊后,该患者在初级保健环境中得到诊断和治疗。尽管罕见,但如果头痛在排除其他头痛原因后仍持续存在,我们应怀疑特发性颅内高压。