Pseudotumor Cerebri Postpartum: A Case Report

Abstract

Idiopathic intracranial hypertension (IIH), called pseudotumor cerebri, could cause postpartum headaches. Generally, this diagnosis is idiopathic and treatment is mainly medical to avoid serious complications of possible vision loss. In this paper, we report the case of a 24-year-old lady who developed a similar constellation of symptoms and was diagnosed with this condition. Postpartum, the patient demonstrated symptoms of headache and vision disturbances. Workup ruled out infectious processes and intracranial pathologies. Normal cranial magnetic resonance imaging (MRI) and high cerebrospinal fluid (CSF) pressure during lumbar puncture led to a diagnosis of IIH. Initiation of medication allowed rapid improvement of symptoms and evaded imminent morbidity. Further discussion in light of the latest findings of the literature is held after the presentation of the case. This case sheds light on the importance on importance of fundoscopy in patients demonstrating new-onset headaches especially postpartum with the absence of intracranial pathologies.

Keywords: acetazolamide; elevated intracranial pressure; nausea and vomiting in pregnancy; postpartum headache; pseudotumor cerebri syndrome (ptcs).

Figure 1. Cranial magnetic resonance imaging of the patient with contrast

A: Coronal cut T2 sequence; B: axial cut T1 sequence with contrast; (C) sagittal cut T1` sequence with contrast. Blue arrows show ventricles without evidence of hydrocephalus. Courtesy of ZHUMC radiology department, Beirut, Lebanon.