Bilateral Papilledema in Idiopathic Intracranial Hypertension: A Case Report

Main Article Content

Anak Agung Dewi Adnya Swari
1Anak Agung Putri Satwika
Putu Nanda Tediantini
Anak Agung Mas Putrawati Triningrat

Keywords

Idiopathic Intracranial Hypertension, Obesity, Headaches, Acetazolamide

Abstract

Introduction: Idiopathic intracranial hypertension (IIH) or known as pseudo tumor cerebri is a challenging condition with raised intracranial pressure (ICP) in the absence of an identifiable cause. IIH occurs predominantly in women, and it has a striking association with obesity. The majority of patients presenting with IIH have symptoms that include a headache and visual disturbances. IIH presents challenges in management. This case report aims to discuss the clinical signs and management of idiopathic intracranial hypertension.


Case Report: A female 21 years old presented with visual field disturbances complaints since one week before admitted to the Hospital. Her symptom progressively worsened over time with headaches. Blood pressure was 150/80 mmHg, body weight was 110 kg, height was 167 cm, and body mass index was 40 kg/m2. Visual acuity in both eyes was 6/6. The intraocular pressure was 17 mmHg on the right eye and 18 mmHg on the left eye. There was a constriction of vision's peripheral field and enlarged blind spot with Humphrey 24-2 visual field test. Fundus examination with optical coherence tomography of retinal nerve fiber layer revealed bilateral papilledema.  The patient was diagnosed with papilledema et causa Idiopathic Intracranial Hypertension in both eyes. The patient was treated with acetazolamide and combination therapy with the neurology department.


Conclusion: IIH is a challenging disease with a collaborative department. Early and aggressive management is required to prevent irreversible visual impairment.

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