Endocrine Abstracts

Introduction: Idiopathic intracranial hypertension (IIH) is characterized by increased intracranial pressure without a detactable cause. Risk factors for the development of this syndrome are obesity and young female population. IIH due to hyperthyroidism is rare in the literature, mentioned in few individual case reports. The exact mechanism of how hyperthyroidism causes IIH is not known. We are reporting the case of a young women with Graves’ disease presenting with symptoms of intracranial hypertension and blindness.

Case presentation: A 38 years old obese women with known Graves’ disease, treated with monotherapy thiamazole, dose of 30 mg once daily during 3 years. Her condition unexpectedly deteriorated by associated moderate to severe active Graves’ orbitopathy, headache, tinnitus, and blindness. Bilateral papillary pallor with blurred edges are found in fundus, the MRI and lumbar puncture showed increased intracranial pressure, but no underlying anatomical cause for the IIH was found. Patient was treated by High-dose systemic glucocorticoids and ventriculoperitoneal shunt. Unfortunately, no improvement of visual function were noticed.

Conclusion: This case report shows the importance of investigating for IIH in a hyperthyroid patient presenting headache associated with visual disturbances by performing a fundus, cerebral MRI angiogram, and CSF pressure measurement in order to preserve the visual function.