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Idiopathic Intracranial Hypertension Progressing to Venous Sinus Thrombosis, Subarachnoid Hemorrhage, and Stroke

Hardin, Joshua, S., MD; Ramakrishnaiah, Raghu, H., MD; Pemberton, John, D., MD; Phillips, Paul, H., MD; Chacko, Joseph, G., MD

Journal of Neuro-Ophthalmology: March 2018 - Volume 38 - Issue 1 - p 60–64
doi: 10.1097/WNO.0000000000000540
Clinical Observation

Abstract: Idiopathic intracranial hypertension (IIH) is a syndrome characterized by increased intracranial pressure (ICP), the absence of structural lesions on neuroimaging, and normal cerebrospinal fluid composition. Cerebral venous sinus thrombosis (CVST) is a common cause of increased ICP and can be differentiated from IIH with magnetic resonance venography. We describe a young woman with typical IIH who underwent lumbar puncture and was treated with a short course of high-dose corticosteroids followed by acetazolamide. She subsequently developed CVST, subarachnoid hemorrhage, and stroke. Risk factors that may have resulted in CVST are discussed.

Jones Eye Institute (JSH, JDP, PHP, JGC), University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas

Departments of Ophthalmology (PHP) and Radiology (RHR), Arkansas Children's Hospital, Little Rock, Arkansas.

Address correspondence to Paul H. Phillips, MD, Arkansas Children's Hospital, 1 Children's Way, Slot 111, Little Rock, AR 72202; E-mail:

The authors report no conflicts of interest.

© 2018 by North American Neuro-Ophthalmology Society