Abstract

Pseudotumor cerebri or benign intracranial hypertension is characterized by increased intracranial hypertension without evidence of a mass lesion or ventricular obstruction. Symptoms are mainly headache and papilledema. If untreated, papilledema can cause progressive irreversible visual loss and optic atrophy. Usually occurs in obese women and in the childbearing years. It is a diagnosis of exclusion and, therefore, other causes of increased intracranial pressure must be sought with history, imaging, and cerebrospinal fluid examination before the diagnosis can be made. MRI findings include empty sella, smooth-walled venous stenoses, flattened globes and fully unfolded optic nerve sheath.

We describe a case of a 13 years old girl who developed L3-L4 spondylodiscitis by Staphylococcus aureus agent. After 2 months of levofloxacin therapy she developed intracranial hypertension, without any evidence of intracerebral mass or hydrocephalus at CT scan and MRI. The levofloxacin therapy was stopped and the symptoms disappeared after same days.

To the best of our knowledge this is the third case of intracranial hypertension associated to levofloxacin described in the literature until now, but many cases associated to fluoroquinolones have been reported.
During levofloxacin therapy it is mandatory knowing this potential complication and to screen patients by ocular fundus in case of clinical symptoms of intracranial hypertension.

Mean pain score prior to any therapy was 8.05±1.449 NVS units. Mean pain score post therapy was 2.37 ± 2.715, 2.42 ± 2.754, 2.70 ± 2.928 and 3.55 ± 2.837 NVS units at 1, 6, 12, 24 months.