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Chronic meningitis mimicking idiopathic intracranial hypertension: a surprising diagnosis

Introduction: Chronic meningitis is a clinical disorder characterized by meningeal inflammation and pleocytosis lasting longer than 4 weeks. It often presents with elevated intracranial pressure, cranial neuropathies, or focal neurologic deficits. Case report: We present a 13-year-old with a headache complaint for about 2 months and papilledema on funduscopic examination. Her brain magnetic resonance imaging and magnetic resonance venography were unremarkable. The cerebrospinal fluid analysis showed elevated protein levels with pleocytosis. No microorganisms were grown in cerebrospinal fluid culture. We considered chronic meningitis mimicking idiopathic intracranial hypertension in the patient. She improved rapidly with antibiotic therapy. Conclusions: Idiopathic intracranial hypertension is a disorder characterized by elevated intracranial pressure. The most common patient symptom is a headache and if there is concomitant papilledema, it is suggested idiopathic intracranial hypertension first. In this context, the case highlights that physicians should not prescribe treatment for idiopathic intracranial hypertension without performing a lumbar puncture.
Keywords: headache, pseudotumor cerebri,chronic meningitis,papilledema