[Benign intracranial hypertension resulting from corticosteroid withdrawal: case report].
We report a case of benign intracranial hypertension (BIH) resulting from corticosteroid withdrawal. A 36-year-old woman was admitted to hospital because of an intractable headache. A neurological examination on admission showed no abnormalities other than a headache and nausea. CT, MRI, and angiogram examinations showed no abnormalities. Hematological and laboratory data were also normal. Continuous monitoring of her cerebrospinal fluid (CSF) pressure showed a value of over 25 mmHg during sleep, but papilledema was not observed. A diagnosis of BIH was made, with corticosteroid withdrawal considered to be the most probable cause. The patient was given isosorbide solution for 3 months. However, her clinical condition continued to deteriorate; she eventually began to develop visual loss, photopsia, and memory disturbances. She underwent lumboperitoneal shunt surgery, which immediately eliminated the headache, photopsia, and memory disturbances. She regained her vision over a five-month period. BIH should be considered as a differential diagnosis when an intractable headache develops after corticosteroid withdrawal, especially in young women.
Saigusa
Kuniyasu
K
Department of Neurosurgery, Haibara General Hospital, 2887-1 Hosoe, Haibara-cho, Haibara-gun, Shizuoka 421-0493, Japan.
Takei
Hidenori
H
Shishido
Tsuneo
T
Ohki
Jun
J
Naoe
Nobuyuki
N
Ohno
Kikuo
K
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D005260:Female; D020773:Headache Disorders / Q000209:etiology; D006801:Humans; D011239:Prednisolone / Q000009:adverse effects*; D011559:Pseudotumor Cerebri / Q000139:chemically induced*; D013375:Substance Withdrawal Syndrome / Q000209:etiology*
D000893:Anti-Inflammatory Agents; D011239:Prednisolone