Idiopathic Intracranial Hypertension Progressing to Venous Sinus Thrombosis, Subarachnoid Hemorrhage, and Stroke

J Neuroophthalmol. 2018 Mar;38(1):60-64. doi: 10.1097/WNO.0000000000000540.

Abstract

Idiopathic intracranial hypertension (IIH) is a syndrome characterized by increased intracranial pressure (ICP), the absence of structural lesions on neuroimaging, and normal cerebrospinal fluid composition. Cerebral venous sinus thrombosis (CVST) is a common cause of increased ICP and can be differentiated from IIH with magnetic resonance venography. We describe a young woman with typical IIH who underwent lumbar puncture and was treated with a short course of high-dose corticosteroids followed by acetazolamide. She subsequently developed CVST, subarachnoid hemorrhage, and stroke. Risk factors that may have resulted in CVST are discussed.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Disease Progression
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Magnetic Resonance Imaging
  • Methylprednisolone / therapeutic use
  • Phlebography
  • Pseudotumor Cerebri / diagnosis*
  • Pseudotumor Cerebri / drug therapy
  • Sinus Thrombosis, Intracranial / diagnosis*
  • Spinal Puncture
  • Stroke / diagnosis*
  • Subarachnoid Hemorrhage / diagnosis*
  • Visual Acuity

Substances

  • Glucocorticoids
  • Methylprednisolone