shirish_sss
Forum Senior
Topics: 32
Posts: 134
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A 25 YEAR OLD, RECENTLY MARRIED, MILDLY OBESE WHITE WOMAN COMES TO HER PHYSICIAN WITH COMPLAINS OF .........
HEADAHCE--- INTERMITTENT, DULL ACHING AND OCASSIONALLY ASSOCIATED WITH NAUSEA AND VOMMITING.
---AND OCASSIONAL BLURRING OF VISION DURING THE PERIODS OF HEADACHES.
---THE OVER ENTHUSIASTIC PHYSICIAN REFERS HER FOR MRI-BRAIN ON THE SAME DAY WHICH TURNS OUT TO BE NORMAL.
---THE PATIENT HAD NO FAMILY HISTORY OF CANCER OR SIMILAR HEADACHES.
---ON EXAMINATION PULSE- 86/min , BP----134/80 mm Hg
WHICH OF THE FOLLOWING COMPLICATION IS SHE MOST LIKELY TO DEVELOP IF HER MEDICAL CONDITION IS NOT INTERVENED ?
1) HYDROCEPHALUS
2) CONVULSIONS
3) PARALYSIS
4) BLINDNESS
5) DEMENTIA
6) URINARY INCONTINENCE
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| smitha
Forum Elite
Topics: 53
Posts: 236
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This kinda presentation fits in fro benign intracranial HTN....is it ??
and if so, then the answer is......4) blindness.........
hope that's correct............ :roll:
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| shirish_sss
Forum Senior
Topics: 32
Posts: 134
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WONDERFUL SMITHA........ :lol: :lol:
YOU CAN NEVER BE WRONG...... :lol: :lol:
THIS IS A CASE OF BENIGN INTRACRANIAL HYTERTENSION OR WHAT WE CALL PSUDOTUMOUR CEREBRI
NOTE THE QUALITY OF HEADACHE.....
IN WHICH OTHER CONDITION DO YOU FIND SUCH A HEADACHE...?
IN BRAIN TUMOURS........YES SMITHA...
THEREFORE ALTHOUGH I REFERRED THE PHYSICIAN AS OVERENTHUSIASTIC IN THE CASE HE IS ACTUALLY INTELLIGENT TO HAVE SEND THE PATIENT FOR MRI-BRAIN........TO RULE OUT BRAIN TUMOURS.....
COMMON CAUSES OF PSUDOTUMOUR CEREBRI ARE OC PILLS(PATIENT IS RECENTLY MARRIED), VIT-A EXCESS AND EVEN CORTICOSTEROIDS AND SOME OTHER DRUGS WHICH I DON'T REMEMBER........
THE FIRST STEP IN MANAGEMENT IS FUNDOSCOPY......YES WE MAY SEE PAPPILOEDEMA.....
MEDICAL MANAGEMENT IS WEIGHT LOSS IF THE PATIENT IS OBESE AND EVEN ACETAZOLAMIDE GIVES GOOD RESULTS IN MANY CASES.....BUT NOT ALL
SO IN THOSE PATIENTS WHERE MEDICAL MANAGEMENT FAILS....
TO PREVENT BLINDNESS......
IN EMERGENCY STUATION WE CAN EVEN DO THERAPEUTIC LP....
OR AN EMERGENCY SHUNT SURGERY.........BUT IN THOSE RARE PATIENTS WHERE MEDICAL AND CONSERVATIVE MANAGEMENT FAILS.....
I HOPE THAT IS ALL WE CAN GET ON STEP-2 ON PSEUDOTUMOUR CEREBRI.....
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| bugsbunny
Forum Junior
Topics: 14
Posts: 54
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could it b Temporal arteritis too?
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| shirish_sss
Forum Senior
Topics: 32
Posts: 134
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GOOD THINKING RINKS...
EVEN I THOUGHT OF IT AT ONE STAGE...
BUT TEMPORAL ARTERITIES EXCLUSIVELY OCCURS IN INDIVIDUALS OLDER THEN 50 YEARS AGE...
ONLY RARELY FEW CASES HAVE BEEN DOCUMENTED IN MEDICAL LITERATURE WHEN IT OCCURED IN PEOPLE LESS THAN 50 YEARS...
PLUS TEMPORAL ARTERITIES ALSO HAS SYSTEMIC SIGNS AND SYMPTOMS LIKE ANEMIA, FEVER, ETC...
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| bugsbunny
Forum Junior
Topics: 14
Posts: 54
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thanx shirish :lol:
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