Secondary intracranial hypertension (pseudotumor cerebri) presenting as post-traumatic headache in mild traumatic brain injury: a case series

Tonia Sabo, Charlene Supnet, Sushmita Purkayastha

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Cerebral edema peaks 36–72 h after moderate traumatic brain injury but thought to be uncommon after mild traumatic brain injury. Post-traumatic headache can develop 48–72 h post-injury, perhaps reflecting the developing cerebral edema. Pseudotumor cerebri can result from various causes, including cerebral edema, and is characterized by increased intracranial pressure, headache, visual, and other common symptoms. Our objective was to report a phenotypically identifiable post-traumatic headache subtype. Case series presentation: This case series of six pediatric patients with post-traumatic pseudotumor cerebri was assessed at 48–120 h post-primary injury with new or a change in symptoms such as headache, vision, auditory, balance, and cognition. Clinical findings included slight fever, neck/head pain, papilledema or cranial nerve deficit (6th), and lack of coordination. Elevated cerebral spinal fluid pressure was documented by lumbar puncture, with no infection. Symptoms improved with treatment specific to post-traumatic headache subtype (lumbar puncture, topiramate, or acetazolamide). Conclusions: Recognition of specific post-traumatic headache subtypes after mild traumatic brain injury will expedite treatment intervention to lower intracranial pressure and resolve symptoms.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalChild's Nervous System
DOIs
StateAccepted/In press - Dec 11 2017

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Post-Traumatic Headache
Brain Concussion
Pseudotumor Cerebri
Intracranial Hypertension
Brain Edema
Headache
Spinal Puncture
Intracranial Pressure
Cerebrospinal Fluid Pressure
Papilledema
Acetazolamide
Cranial Nerves
Neck Pain
Wounds and Injuries
Ataxia
Cognition
Fever
Pediatrics
Therapeutics
Infection

Keywords

  • Acetazolamide
  • Concussion
  • Idiopathic intracranial hypertension
  • Intracranial pressure
  • Post-traumatic headache
  • Pseudotumor cerebri

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

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title = "Secondary intracranial hypertension (pseudotumor cerebri) presenting as post-traumatic headache in mild traumatic brain injury: a case series",
abstract = "Background: Cerebral edema peaks 36–72 h after moderate traumatic brain injury but thought to be uncommon after mild traumatic brain injury. Post-traumatic headache can develop 48–72 h post-injury, perhaps reflecting the developing cerebral edema. Pseudotumor cerebri can result from various causes, including cerebral edema, and is characterized by increased intracranial pressure, headache, visual, and other common symptoms. Our objective was to report a phenotypically identifiable post-traumatic headache subtype. Case series presentation: This case series of six pediatric patients with post-traumatic pseudotumor cerebri was assessed at 48–120 h post-primary injury with new or a change in symptoms such as headache, vision, auditory, balance, and cognition. Clinical findings included slight fever, neck/head pain, papilledema or cranial nerve deficit (6th), and lack of coordination. Elevated cerebral spinal fluid pressure was documented by lumbar puncture, with no infection. Symptoms improved with treatment specific to post-traumatic headache subtype (lumbar puncture, topiramate, or acetazolamide). Conclusions: Recognition of specific post-traumatic headache subtypes after mild traumatic brain injury will expedite treatment intervention to lower intracranial pressure and resolve symptoms.",
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AU - Supnet, Charlene

AU - Purkayastha, Sushmita

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AB - Background: Cerebral edema peaks 36–72 h after moderate traumatic brain injury but thought to be uncommon after mild traumatic brain injury. Post-traumatic headache can develop 48–72 h post-injury, perhaps reflecting the developing cerebral edema. Pseudotumor cerebri can result from various causes, including cerebral edema, and is characterized by increased intracranial pressure, headache, visual, and other common symptoms. Our objective was to report a phenotypically identifiable post-traumatic headache subtype. Case series presentation: This case series of six pediatric patients with post-traumatic pseudotumor cerebri was assessed at 48–120 h post-primary injury with new or a change in symptoms such as headache, vision, auditory, balance, and cognition. Clinical findings included slight fever, neck/head pain, papilledema or cranial nerve deficit (6th), and lack of coordination. Elevated cerebral spinal fluid pressure was documented by lumbar puncture, with no infection. Symptoms improved with treatment specific to post-traumatic headache subtype (lumbar puncture, topiramate, or acetazolamide). Conclusions: Recognition of specific post-traumatic headache subtypes after mild traumatic brain injury will expedite treatment intervention to lower intracranial pressure and resolve symptoms.

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