Benign ICT due to respiratory condition?

Posted by Dr. Raghavan Dr. Raghavan
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A lady, 43 years old, post kidney transplant 5 years ago was referred to me because she complained of severe headache of about a week duration. She was found to have bilateral papilloedema with normal visual acuity with no other abnormality in general fundus. OCT confirmed papilloedema.
Visual fields were normal.MRI was normal.This was about three weeks ago. She was being treated for IIH and was put on Tab Acetazolamide 250 mg twice a day.She became asymptomatic.Subsequently about ten days ago, she devoloped severe dyspnoea even on slight exertion for which a CT chest was ordered by the nephrologist and it showed some pulmonary vessels pathology. I do not have the details but she was admitted and treated.

She came for a review yesterday and to my surprise, there was definate venous pulsations in the disc veins in both eyes, though there was not much change in the appearance of the discs.Presence of venous pulasations in a discedema means the ICT is less 170 mm of water, suggesting regression of edema in this case.

My inference is raised ICT was because of respiratory condition.Can I have your views and advice on this.

2 Comments

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Dr. Thamburaj Dr. Thamburaj
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Re: Benign ICT due to respiratory condition?

Your problem is interesting.
As u know no one knows the exact cause for IIH. Your patient seems to have had many predisposing factors such as hormonal factors in a woman during her menopause, anemia and vitamin deficiencies due to her chronic renal problem, history of renal transplant with long term antibiotics and subsequent steroids which might have been stopped. The same causes can ppt a chest problem as well.

Chest conditions have a role in increasing further increase in ICT in those with increased ICT. I do not think her raised ICT was primarily due to her chest problem. Unfortunately, I could not access your full article.
I hope this comment is of help to you.
Dr Riaz Dr Riaz
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Re: Benign ICT due to respiratory condition?

In reply to this post by Dr. Raghavan
Yes, indeed chronic chest problmes, (COPD) and even OSA syndromes can to some extent produce benign ICP but being a women one had to ask ourselves, whether she is on fertlitiy related medications including OCD and then to look into endocrine profile.