Benign but not harmless intracranial hypertension: a case report

• Published in: Archives de pédiatrie : organe officiel de la Société française de pédiatrie 2010-12, Vol.17 (12), p.1677-1681
• Main Authors: Duclos, C, Bonnin, N, Merlin, E, Viorel, A, Lacombe, P, Dalens, H, Chiambaretta, F, Deméocq, F, Chazal, J, Kanold, J
• Format: Article
• Language: fre
• Subjects: Abducens Nerve Diseases - virology; Acetazolamide - administration & dosage; Adolescent; Diplopia - virology; Diuretics - administration & dosage; Female; Humans; Meningitis, Viral - complications; Meningitis, Viral - diagnosis; Meningitis, Viral - drug therapy; Papilledema - virology; Prognosis; Pseudotumor Cerebri - diagnosis; Pseudotumor Cerebri - drug therapy; Pseudotumor Cerebri - virology; Spinal Puncture; Treatment Outcome
• ISSN: 0929-693X; 1769-664X
• DOI: 10.1016/j.arcped.2010.09.012

Benign intracranial hypertension (BIH) is characterized as an intracranial pressure increase occurring in the absence of brain tumour, sinus thrombosis or hydrocephaly. But contrary to what its designation might suggest, it threatens the visual prognosis. We report the case of a 15-year-old girl with lymphocytic meningitis, developing secondary a BIH. Cerebrospinal fluid pressure was 70cm water, without enlargement of the cerebral ventricles. Along with the progression, bilateral 6th nerve palsy, impairment of visual acuity and bilateral papilledema appeared. No cause was found after a complete assessment. Treatment consisted in oral acetazolamide and 9 depletive spinal taps. Clinical examination, fundus examination and Goldmann visual field normalized after 8 weeks. No relapse occurred after a 1-year follow-up. This case shows that BIH, which is not a well-known disorder, is incorrectly referred to as benign: both prompt diagnosis and proper management are of major importance.