Diagnosis and treatment of malignant intracranial hypertension: one case report

Objective This paper reports a case of malignant intracranial hypertension, reviews his diagnosis and treatment, and analyzes his etiology, in order to improve the clinicians' cognition of this disease. Methods and Results The patient was a 19⁃year⁃old male with subacute onset and chronic course of disease, presenting with amaurosis, headache, neck and shoulder pain, blurred vision and tinnitus disease. Imaging findings showed cerebral venous sinus stenosis (VSS) with obvious pressure difference at both ends of stenosis. However, venous sinus stenting was ineffective. After optic nerve sheath decompression, the symptoms of headache and blurred vision were not significantly improved. Finally, the patient was diagnosed as glioblastoma (WHO Ⅳ), and died 8 months after removal of the tumor foci. Conclusions Patients with the pressure difference at both ends of malignant intracranial hypertension with VSS should not take stenting. Clarifying the cause and type of stenosis is very important for correct diagnosis and guide treatment.