IDIOPATHIC INTRACRANIAL HYPERTENSION WITHOUT HEADACHE: A CASE REPORT and LITERATURE REVIEW

Abstract

SummaryIn this article, a 23-year-old man who has an idiopathic intracranial hypertension (IIH) case is presented with blurred vision and diplopia, without headaches is reported. Although headache is the most common symptom seen in IIH, sometimes it may not be observed clinically. This situation is defined more in males in young and children and thin patients. Crucial point here is that they are being presented with serious visual evidence, so they must be aggressively treated.Keywords: Headache; idiopathic intrcarial hypertension; men; papil edema. ÖzetBu yazıda başağrısı olmaksızın, bulanık görme ve diplopi ile presente olan, 23 yaşında erkek İdiopatik intrakranial hipertansiyon (İİH) olgusu bildirilmiştir. İHH'de başağrısı en sık görülen semptom olmasına rağmen, bazen klinik olarak görülmeyebilir.Bu durum daha çok erkeklerde gençler özellikle çocuklarda ve zayıf hastalarda tanımlanmıştır. Buradaki önemli nokta bu hastalar ciddi görsel bulgularla presente olmaktadırlar, bu nedenle agresif tedavi edilmelidirler.Anahtar sözcükler: Başağrısı; idiopatik intrakranial hipertansiyon; erkek; papil ödem.

“Benign intracranial hypertension” is a misleading name for a more serious disease: analysis of the visual outcome in cases with idiopathic intracranial hypertension

“…Friedman et al [18] connected the intermittent course of the headache to the natural fluctuations in CSF pressure throughout the day. Eren et al [3] reported that the differences in ventricular compliance and the duration of increased intracranial pressure could explain the clinical differences between IIH patients with or without headaches; they performed a retrospective study of 152 children with IIH, and 14.5% of the patients had no headache.…”

“…The most common presentation of patients with idiopathic intracranial hypertension is headache, visual changes, and papilledema, which, if left untreated, may lead to permanent loss of vision [3]. The poor visual outcome is usually associated with early onset of reduced vision, optic disc hemorrhages, grade 4 papilledema, and a high body mass index [4].…”

Estudio de los polimorfismos de las acuaporinas 1 y 4, leptina sérica y fístula espontánea de líquido cefalorraquídeo en la hipertensión intracraneal idiopática

“…La incidencia en la población general es de 0,5-2 de cada 100.000 personas/año aumentando en las mujeres jóvenes con obesidad hasta 12-20 de cada 100.000 personas/año (1,2,17,19,20,22) . La prevalencia en hombres y en niños no está clara debido a la falta de estudios epidemiológicos (1) .…”

“…La mayoría de los pacientes con HII sufren sobrepeso u obesidad y algunos experimentan un incremento de peso en los meses previos al diagnóstico (1) . Un incremento del peso igual o mayor al 5% (22) implica un aumento del riesgo de padecer la enfermedad en las personas no obesas. La obesidad contribuye a un empeoramiento de la sintomatología en pacientes en los que la PIC ha sido tratada (23) .…”

“…Además, medicamentos para tratar la cefalea como los antitricíclicos pueden causar un aumento de peso en el paciente y dificultar la pérdida de peso corporal (1)(2)(3)9,10,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)69,70) .…”