Tisdall
A 21-year-old female presents to the clinic with a headache and diplopia. The headache started one week ago and is worse in the morning. She describes the pain as generalized and throbbing in nature. No triggering factors are identified, but the headaches are associated with nausea and now, double vision. She has never had these symptoms before. She denies drowsiness, incontinence, cognitive disturbances and any congenital head abnormalities. Review of system A physical evaluation is positive for acne, which she is being treating for with isotretinoin. Temperature is 37 °C (98.6°F), Hheart rate is 98 beats/ per min, Rrespiratory rate is 18 breaths/ per min, Bblood pressure is 150/80 mmHg, and BMI is 52. Physical examination reveals papilledema and partial weakness of the left abducens nerve. Which of the following is expected during the patient’s workup?
A. Abnormal EMG studies.
B. MRI showing multiple T1 “hypodense areas”
C. MRI showing no abnormalities.
D. Normal opening pressure during lumbar puncture.
E. Widening of lateral and third ventricle on MRI.
Answer …show more content…
Idiopathic Intracranial Hypertension (IIH) or pseudotumor cerebri is a neurologic disease with increased intracranial pressure in the absence of intracranial tumors or pathologies. It is common in young, obese females with history of Vitamin A use or contraceptives use. Symptoms are related to elevated intracranial pressure, and range from headache, the most common symptom, to diplopia, radicular pain, and visual loss (progressive or sudden) resulting from papilledema. Imaging studies should be done to rule out any intracranial lesions. After imaging, a lumbar puncture is indicated for both therapeutic and diagnostic purposes. In the absence of any intracranial lesions, a markedly elevated opening pressure during a lumbar puncture will diagnose IIH. Neuroimaging studies, such, as MRI and CT, are
A 21-year-old female presents to the clinic with a headache and diplopia. The headache started one week ago and is worse in the morning. She describes the pain as generalized and throbbing in nature. No triggering factors are identified, but the headaches are associated with nausea and now, double vision. She has never had these symptoms before. She denies drowsiness, incontinence, cognitive disturbances and any congenital head abnormalities. Review of system A physical evaluation is positive for acne, which she is being treating for with isotretinoin. Temperature is 37 °C (98.6°F), Hheart rate is 98 beats/ per min, Rrespiratory rate is 18 breaths/ per min, Bblood pressure is 150/80 mmHg, and BMI is 52. Physical examination reveals papilledema and partial weakness of the left abducens nerve. Which of the following is expected during the patient’s workup?
A. Abnormal EMG studies.
B. MRI showing multiple T1 “hypodense areas”
C. MRI showing no abnormalities.
D. Normal opening pressure during lumbar puncture.
E. Widening of lateral and third ventricle on MRI.
Answer …show more content…
Idiopathic Intracranial Hypertension (IIH) or pseudotumor cerebri is a neurologic disease with increased intracranial pressure in the absence of intracranial tumors or pathologies. It is common in young, obese females with history of Vitamin A use or contraceptives use. Symptoms are related to elevated intracranial pressure, and range from headache, the most common symptom, to diplopia, radicular pain, and visual loss (progressive or sudden) resulting from papilledema. Imaging studies should be done to rule out any intracranial lesions. After imaging, a lumbar puncture is indicated for both therapeutic and diagnostic purposes. In the absence of any intracranial lesions, a markedly elevated opening pressure during a lumbar puncture will diagnose IIH. Neuroimaging studies, such, as MRI and CT, are