Intracranial hypertension: a three year experience at military hospital, Rawalpindi

ABSTRACT

Idiopathic intracranial hypertension is a syndrome associated with multiple clinical conditions and is an important mimicker of cerebral venous thrombosis. Given the difference in prognosis of these two conditions they should be differentiated. This study was carried out in indoor and outdoor patients from 1998 to 2000 in Military hospital Rawalpindi. All patients who presented with headache and papilloedema were evaluated further as per protocol after informed consent. Out of 40 registered patients, 12 [30%] were male and 28 [70%] female. The age range was 18 to 45 years, mean was 27.28 + 6.64 years. On neuroimaging 16 [40%] patients found to be suffering from dural sinus thrombosis and all patients had a normal CT scan. Among 16 patients with dural sinus thrombosis 1 [6.3%] patient had protein C deficiency, 2 [12.5%] had pregnancy, 1 [6.3%] had postpartum haemoohage, 1 [6.3%] had puerperal sepsis, 5 [31.3%] were evaluated from high altitude, 1 [6.3%] had ear infection, 1 [6.3%] had factor V Leiden, 1 [6.3%] had antiphospholipid antibody syndrome and in the remaining 3 [18.75%] no etiology was found. In patients with isolated raised intracranial pressure a high index of suspicion should be kept for cerebral venous thrombosis as an underlying etiology especially when it occurs with the background of a hypercoaguable state