Abstract:
Idiopathic intracranial hypertension (IIH) is a rare condition characterized by increased intracranial pressure, with an unknown cause. However, the pathophysiology of antibiotic-induced IIH remains unclear. The clinical symptoms include headache, visual disturbances, and vomiting. The diagnosis is confirmed by an elevated intracranial pressure (ICP) with normal CSF study and cerebral imaging. Management includes discontinuing the offending antibiotic and reducing ICP with medications such as acetazolamide or diuretics. Therefore, surgical intervention may be necessary in severe cases. In this article, we report the case of a 19-year-old patient, admitted with symptoms of intracranial hypertension syndrome, occurring three days after receiving antibiotics (gentamicin, penicillin). Physical examination revealed bilateral optic disc edema. Cerebral magnetic resonance imaging (MRI) revealed indirect signs of intracranial hypertension. The CSF pressure measurement was approximately 290 mmHg, while CSF and other laboratory blood tests were normal. The patient received methylprednisolone bolus and topiramate (50 mg/day). A month later, the clinical outcome showed regression of headaches and regression of the papilledema.
摘要:
特发性颅内高压(IIH)是一种罕见的疾病,其特征是颅内压升高,一个未知的原因。然而,抗生素诱导的IIH的病理生理学尚不清楚.临床症状包括头痛,视觉障碍,和呕吐。通过正常的CSF研究和脑成像,颅内压(ICP)升高证实了诊断。管理包括停用有问题的抗生素,并使用乙酰唑胺或利尿剂等药物降低ICP。因此,在严重的情况下,手术干预可能是必要的。在这篇文章中,我们报道了一个19岁的病人,患有颅内高压综合征的症状,发生在接受抗生素后三天(庆大霉素,青霉素)。体格检查发现双侧视盘水肿。脑磁共振成像(MRI)显示颅内高压的间接迹象。CSF压力测量值约为290mmHg,而脑脊液和其他实验室血液检查正常。患者接受甲基强的松龙推注和托吡酯(50mg/天)。一个月后,临床结果显示头痛消退,乳头水肿消退.