# Antibiotics-Induced Intracranial Hypertension: A Case Report With Literature Review

## TL;DR

A 19-year-old patient developed intracranial hypertension after receiving antibiotics, and symptoms improved after treatment with methylprednisolone and topiramate.

## Contribution

This case report adds to the understanding of antibiotic-induced intracranial hypertension and its successful management.

## Key findings

- The patient showed regression of headaches and papilledema after treatment.
- MRI revealed indirect signs of intracranial hypertension.
- CSF pressure was elevated at 290 mmHg with normal CSF and blood tests.

## Abstract

Idiopathic intracranial hypertension (IIH) is a rare condition characterized by increased intracranial pressure, with an unknown cause. However, the pathophysiology of antibiotic-induced IIH remains unclear. The clinical symptoms include headache, visual disturbances, and vomiting. The diagnosis is confirmed by an elevated intracranial pressure (ICP) with normal CSF study and cerebral imaging. Management includes discontinuing the offending antibiotic and reducing ICP with medications such as acetazolamide or diuretics. Therefore, surgical intervention may be necessary in severe cases.

In this article, we report the case of a 19-year-old patient, admitted with symptoms of intracranial hypertension syndrome, occurring three days after receiving antibiotics (gentamicin, penicillin). Physical examination revealed bilateral optic disc edema. Cerebral magnetic resonance imaging (MRI) revealed indirect signs of intracranial hypertension. The CSF pressure measurement was approximately 290 mmHg, while CSF and other laboratory blood tests were normal. The patient received methylprednisolone bolus and topiramate (50 mg/day). A month later, the clinical outcome showed regression of headaches and regression of the papilledema.