title: Successful electroconvulsive therapy in a drug-refractory depressed patient with idiopathic intracranial hypertension.
abstract: The condition of a 42-year-old woman with drug-refractory major depression, severe headache, and progressive visual impairment was diagnosed as idiopathic intracranial hypertension (IICH). Idiopathic intracranial hypertension is a relative contraindication to electroconvulsive therapy (ECT), chiefly due to the theoretical risk of brain herniation. Although the diagnosis of IICH was unequivocal, the patient's headache was interpreted as being unassociated with IICH. Nine ECT sessions were performed, and both depression and headache improved dramatically. People with IICH are at an increased risk of depression and report more physical complains, including headache. Cases of IICH may be considered for ECT if depression is drug-refractory. In this case, cerebrospinal fluid open pressure should be closely monitored.
authors.affiliation: Psychiatry Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Mirela V
authors.initials: MV
authors.lastname: Moreno
authors.forename: Matheus R
authors.initials: MR
authors.lastname: Cruz
authors.forename: Carlos R M
authors.initials: CR
authors.lastname: Rieder
authors.forename: Marcelo P
authors.initials: MP
authors.lastname: Fleck
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000150:complications* / Q000628:therapy*; D004351:Drug Resistance; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D011559:Pseudotumor Cerebri / Q000150:complications*; D016896:Treatment Outcome