Iron Deficiency Without Anaemia in a Young Female With Idiopathic Intracranial Hypertension: A Case Report Supporting Routine Iron Studies

Idiopathic intracranial hypertension (IIH) is common in young, overweight women, but less recognised factors - such as iron deficiency - may also play a role. We report the case of a 19-year-old female with polycystic ovary syndrome who presented with headaches, pulsatile tinnitus, and transient visual obscurations; examination showed grade 1 papilledema. Neuroimaging demonstrated features of raised intracranial pressure (ICP) without mass lesion or venous sinus thrombosis, and lumbar puncture confirmed an elevated opening pressure of 39 cm H₂O. Blood tests revealed iron deficiency without anaemia (ferritin 21 µg/L, transferrin saturation 15%, hemoglobin [Hb] 121 g/L). Her symptoms improved after the lumbar puncture, and she was managed with iron supplementation and lifestyle advice for weight loss, with migraine prophylaxis also considered. This report highlights iron deficiency, even without overt anaemia, as a potential modifiable factor in IIH. Screening iron studies should be considered in young females presenting with IIH symptoms.