7.1.1 Headache attributed to idiopathic intracranial hypertension (IIH)

Identification Patient: Female, 32 years old Past medical history: Grade I obesity (BMI 32 kg/m²) Family history: No relevant neurological history Clinical History The patient presents with a chronic progressive headache for 3 months, of moderate to severe intensity, with a holocranial and pressure pattern, without specific triggers. She reports worsening in the morning and when performing Valsalva maneuvers. She also reports bilateral pulsatile tinnitus and transient episodes of visual blurring. Neurological Examination Bilateral papilledema detected on fundoscopic examination Perimetry: Transient scotomas Ocular movements: Presence of left sixth cranial nerve palsy Others: No signs of meningeal irritation, no motor deficits Complementary Exams Cranial MRI: Partially empty sella turcica, flattening of the posterior sclera, and distension of the perioptic subarachnoid space. MR Angiography: Bilateral transverse sinus stenosis. Lumbar puncture in lateral decubitus: Opening pressure: 280 mmH2O CSF of normal composition