A 29-year-old, generally healthy woman comes to your clinic with a 1-month history of intermittent headache without nausea and vomiting. She describes the headache as some time throbbing, but other times pressure. She states that she occasionally experiences blurry vision.
She denies a history of head trauma, cigarette smoking, drinking alcohol beverages or using illicit drugs. There is no family history of headaches.
On physical examination, she appears to be healthy and is in no acute distress. Her vital signs are stable without fever. Her pupils are equal in size, round and reactive to light and accommodation. Fundi show bilateral papilledema which is later confirmed by an ophthalmologist. Lung and cardiac examinations are normal. The remainder of the physical examination is normal. Neurological examination is grossly intact.
Lab results including CBC and chemo profiles are normal. CSF studies reveal an increased opening pressure, otherwise normal.
Brain MRI reveals no tumors or lesions but flattening of the posterior globe.
What is the most likely diagnosis?
What is the most serious consequence of this disease?
She denies a history of head trauma, cigarette smoking, drinking alcohol beverages or using illicit drugs. There is no family history of headaches.
On physical examination, she appears to be healthy and is in no acute distress. Her vital signs are stable without fever. Her pupils are equal in size, round and reactive to light and accommodation. Fundi show bilateral papilledema which is later confirmed by an ophthalmologist. Lung and cardiac examinations are normal. The remainder of the physical examination is normal. Neurological examination is grossly intact.
Lab results including CBC and chemo profiles are normal. CSF studies reveal an increased opening pressure, otherwise normal.
Brain MRI reveals no tumors or lesions but flattening of the posterior globe.
What is the most likely diagnosis?
What is the most serious consequence of this disease?
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コメント(3)
Please tell me If there"s some misunderstaning,,,
This is just my thinking without textbook....<(_ _)>
1. from 1 month history of headache,,,,
common -> migraine,
2. young women + vision
-> Giant cell arthritis, Multiple myeloma
BUT
3. papille edema + CSF increase
more likely -> Intracranial mass (maybe Brain tumor??)
but without Vomitting, nausea, morning headache is unlikely,,,
maybe Normal Pressuree Hydroencephalitis??
(but no ataxia nor dimentia,,,,,)
this is only I can think about now....
I have to look up for my textbook for more exact disease....
<(_ _)>
This is just my thinking without textbook....<(_ _)>
1. from 1 month history of headache,,,,
common -> migraine,
2. young women + vision
-> Giant cell arthritis, Multiple myeloma
BUT
3. papille edema + CSF increase
more likely -> Intracranial mass (maybe Brain tumor??)
but without Vomitting, nausea, morning headache is unlikely,,,
maybe Normal Pressuree Hydroencephalitis??
(but no ataxia nor dimentia,,,,,)
this is only I can think about now....
I have to look up for my textbook for more exact disease....
<(_ _)>
I looked up the book.....
no lesion w/ MRI unlikely in Tumor , abscess and multiple sclerosis (MM is my mistake...)
I'm not sure about non-bacterial meningitis (but they are usualy unusual CSF lab,
except TB which needs special culture sometimes )
In the book
There is a term "Peudotumor cerebri".
- Thrombosis @ transverse venous sinus, sigital sinus
-Chronic pulmonary disease
-Endocrintive disturbance (ex. thyroid/ Addison)
-Vit A toxicity
-Tetracycline , OCT, Withdraw of corticosteroid
There is also mention of "Arnold- chiari malformation"
######################################
Maybe they are not right, but this is all I can think about.....
And maybe
I need to mention about rule outing "Pregnant(Preeclampsia)" by Urine test.
( I assumed it"s negative because Imaging already done and normal BP)
no lesion w/ MRI unlikely in Tumor , abscess and multiple sclerosis (MM is my mistake...)
I'm not sure about non-bacterial meningitis (but they are usualy unusual CSF lab,
except TB which needs special culture sometimes )
In the book
There is a term "Peudotumor cerebri".
- Thrombosis @ transverse venous sinus, sigital sinus
-Chronic pulmonary disease
-Endocrintive disturbance (ex. thyroid/ Addison)
-Vit A toxicity
-Tetracycline , OCT, Withdraw of corticosteroid
There is also mention of "Arnold- chiari malformation"
######################################
Maybe they are not right, but this is all I can think about.....
And maybe
I need to mention about rule outing "Pregnant(Preeclampsia)" by Urine test.
( I assumed it"s negative because Imaging already done and normal BP)
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