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Idiopathic intracranial hypertension — SCE Acute Medicine MCQ

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HardNeurology and ophthalmologyIdiopathic intracranial hypertensionSCE Acute Medicine

A 43-year-old woman with a new severe headache has BP 168/92 mmHg and papilloedema. She is obese and takes tetracycline for acne. CT venogram shows no venous sinus thrombosis. Lumbar puncture opening pressure is 38 cm CSF with normal constituents. What is the most likely diagnosis?

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Correct answer: E — Idiopathic intracranial hypertension

Raised opening pressure with normal CSF, papilloedema and typical risk factors supports idiopathic intracranial hypertension. Tetracyclines can precipitate raised intracranial pressure and should be stopped. Bacterial meningitis would usually have CSF pleocytosis, and giant cell arteritis is unusual at this age.

Reference: ABN IIH Guidance; NICE CKS Headache