HIPERTENSÃO INTRACRANIANA IDIOPÁTICA NÃO RESPONSIVA AO TRATAMENTO MEDICAMENTOSO: RELATO DE CASO

Introduction: Idiopathic intracranial hypertension (IIH) is a type of secondary headache that occurs due to increased intracranial pressure (ICP) of unknown origin. It is a complex and disabling neurometabolic disease that mainly affects women of childbearing age with obesity, the incidence of which is increasing with the world's obesity epidemic. Objective: To report the clinical case of a patient with IBH who did not respond to the drug treatment prescribed and required surgery to resolve the condition. Case report: We report the case of a 46-year-old female patient with a BMI of 31.1, with a history of migraine and hypertension, diagnosed with IBH after a worsening headache associated with visual alterations, insomnia and imbalance, resulting in disability. She began treatment with acetazolamide and topiramate, but there was no satisfactory response, and she underwent ventriculo-peritoneal shunt placement, which resulted in an improvement in her headache and quality of life. Discussion: The treatment of IIH aims to reduce intracranial pressure, resolve the headache and preserve vision. Most individuals respond to first-line therapy with weight loss, acetazolamide or topiramate. Refractory or fulminant cases require surgical intervention, as in the case reported here. Ventriculo-peritoneal shunt has a high rate of improvement in headache and papilledema despite the risk of complications. Conclusion: The case reinforces the importance of early diagnosis and intervention to resolve symptoms and preserve vision, altering the prognosis of the disease and promoting patients' quality of life in the short and long term.