Ochsner Health System, Department of Neurosurgery, Ochsner Neuroscience Institute, Ochsner Clinic Foundation, New Orleans, LA; Tulane Medical Center, Department of Neurosurgery, New Orleans, LA, USA.
Tulane Medical Center, Department of Neurosurgery, New Orleans, LA, USA.
Clin Neurol Neurosurg. 2021 Oct;209:106910. doi: 10.1016/j.clineuro.2021.106910. Epub 2021 Aug 30.
Idiopathic Intracranial Hypertension (IIH) typically occurs in obese (BMI >30 kg/m) females of childbearing age in the absence of any apparent intracranial space-occupying lesion. Patients typically present with headache, nausea, vomiting, tinnitus, and blurry vision secondary to increased intracranial pressure, with more severe cases involving cranial neuropathies and ophthalmological manifestations. Complete ophthalmoplegia is a rare event in IIH. In such cases, aggressive management with pharmacological, endovascular, and surgical intervention is essential to hasten recovery and limit long-term neurological and visual deficits. Herein, we present a rare case of a patient with IIH associated with third, fourth, and sixth cranial nerve palsies, resulting in complete unilateral ophthalmoplegia, who underwent dural sinus stenting and 2.5-year follow-up revealed complete resolution with full extraocular movements. We also perform a systematic literature review of complete and partial ophthalmoplegia secondary to IIH, highlighting the associated presentations, pathophysiology, management, and outcomes.
特发性颅内高压（IIH）通常发生在肥胖（BMI＞30kg/m²）的育龄期女性中，且不存在任何明显的颅内占位性病变。患者通常表现为头痛、恶心、呕吐、耳鸣和视力模糊，这是由于颅内压升高引起的，更严重的病例还会涉及颅神经病变和眼科表现。在 IIH 中，完全性眼肌麻痹是一种罕见的情况。在这种情况下，必须进行积极的药物、血管内和手术干预，以加快恢复并限制长期的神经和视觉缺陷。在此，我们报告一例罕见的 IIH 相关的第三、第四和第六脑神经麻痹导致单侧完全性眼肌麻痹的病例，该患者接受了硬脑膜窦支架置入术，2.5 年的随访显示完全缓解，外眼肌运动完全恢复。我们还对 IIH 引起的完全性和部分性眼肌麻痹进行了系统的文献回顾，强调了相关的表现、病理生理学、治疗和结果。
