Somali Medical Forums
Medical Student Forums => Problem-Based Learning Center => Topic started by: Dr.Adnan on November 09, 2011, 05:02:30 AM
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20 years old female patient presented with projectile vomiting and morning headache of 3 weeks duration, the patient is overweight and was using anti-acne medications excessively. on examination the patient is found to have papilledema.
1-What is the next investigation you would do?
2-If it came back negative , What is the most likely diagnosis?
3-What is the most worrisome sequale/complication?
4-How would you manage this patient?
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1. visual field testing. MRI brain and MR venography and lumbar punctures with CSF opening pressures measured and a CSF sample sent for analysis.
2. pseudotumor cerebri/iih
3. visual loss
4. medication :acetazolamide, surgery :NII sheath decompression, shunting
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Correct Irwan,,,Except
1- CT-scan,,,Since There is papilledema and history is suggestive of increased ICP you don't want to rush lumber puncture, Rule out any mass lesions (e.g a tumor) ,,, Visual field testing is done once you rule out more serious conditions and made the dx of Pseudomotor cerebri.
2-Correct,,Text book case of Pseudomotor cerebri (young Obese female with hypervitaminosis A -- tx For acne)
3-Correct,,,, Visual loss due to chronic papilledema
4-Correct,,,There is no specific management for pseudo-motor cerebri, the aim is to decrease ICP...