One of my patients complains of a constant throbbing headache which is worse in the morning and when she coughs. She often feels sick and has noticed that her vision fades for a few seconds before becoming normal again. She is 25 years old and is very overweight. What is going on?

This has all the signs of chronic raised intracranial pressure.

This is a build-up of pressure around the brain and in the chronic form is rare and sometimes it’s not clear why it happens.

Symptoms can include:

Constant throbbing headache which may be worse in the morning, or when coughing or straining; it may improve when standing up

Temporary loss of vision –it may become dark or grey for a few seconds; this can be triggered by coughing, sneezing or bending down

Feeling and being sick

Feeling sleepy

Feeling irritable.

There may be a sudden onset unilateral esotropia (inward eye turn) as pressure is put on the sixth cranial nerve.

There is a danger of optic nerve atrophy because of pressure on the optic nerve.

When the cause is unclear it is called idiopathic intracranial hypertension. This commonly occurs in overweight women between 20 and 30 years old.

This patient needs to be referred to their general practitioner and then to a neurologist.

 

 

0 Comments

Submit a Comment

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.

If you like EyeTools Questions of the Day…

Children’s Eye Examinations
How to Run a Successful Low Vision Clinic
How to Run a Successful Optometry Practice

EyeTools.Education

 

NEW WEBINARS ADDED REGULARLY – this is for:
– Optometry students
– Pre-registration and novice optometrists
– Optometrists returning to work
– Junior eye doctors
– Dispensing opticians and orthoptists preparing for refraction exams
– Contact lens opticians, clinical assistants and eyecare educators

Improve your optometry skills with introductory & specialist instruction videos, topical live & recorded expert webinars, presentations and book reviews.

Start with the first section, ‘Pre-refraction procedures’ free, then choose a monthly or yearly subscription. To see English captions, click the CC button on any video.