Pseudotumor cerebri in pregnant obese patient: A case report

Introduction: Pseudotumor cerebri (PTC), idiopathic intracranial hypertension, is a serious condition that is most associated with pregnancy. It is believed that symptoms are due to increased stroke volume and fluid retention ultimately increasing intracranial pressure. This increased pressure can lead to cerebral edema and dysfunction of the optic nerve fibers. The initial workup for PTC is conducting a computed tomography (CT) or magnetic resonance imaging (MRI) brain scan to rule out structural abnormalities that may induce a headache. A lumbar puncture can be performed to acutely relieve the symptoms and definitively diagnose PTC; however, the definitive treatment is acetazolamide through the inhibition of carbonic anhydrase alleviating intracranial pressure. Case Report: This case report discusses how a pseudotumor cerebri affected the pregnancy of a 29-year-old female who presented with headache, blurry vision with eye pain, and abdominal pain. Her pregnancy was complicated by several comorbidities. Ultrasound showed a viable intrauterine pregnancy, while an MRI without contrast of the head revealed bilateral papilledema. She was treated with acetazolamide and underwent a primary low transverse cesarean section due to fetal malpresentation and pseudotumor cerebri diagnosis. Conclusion: It is imperative that symptoms of PTC are recognized as a larger diagnosis and that imaging confirms the increased intracranial pressure. The initial workup for PTC is conducting a CT or MRI brain scan to rule out structural abnormalities that may induce a headache. A lumbar puncture can relieve the symptoms and definitively diagnose PTC. The definitive treatment is acetazolamide through the inhibition of carbonic anhydrase alleviating intracranial pressure.