Summary of Case

A 19-year-old woman with chronic headaches presents with 1 month of worsening headache and diplopia. Her headache is associated with photophobia and phonophobia, is worse in the supine position, and recently associated with nausea and vomiting. She has horizontal diplopia improved by covering either eye, as well as pulsatile tinnitus. Her exam is remarkable for intact monocular vision acuity, mild bilateral abducens nerve palsies, and mild-to-moderate bilateral optic disk edema (Figure 1). She had an MRI of the brain showing mild flattening of the posterior sclera of the globes (Figure 2) and narrowing of the transverse venous sinuses bilaterally. Ocular coherence tomography (OCT) showed bilateral increased thickness of the retinal nerve fiber layer (RNFL) to 333 and 356 μm. A lumbar puncture was notable for an opening pressure of 29 cm H₂O.

中文翻译：

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19 岁女性头痛、视乳头水肿和复视一例

案例总结

一名患有慢性头痛的 19 岁女性出现 1 个月的头痛和复视恶化。她的头痛与畏光和畏声有关，仰卧位时更严重，最近还伴有恶心和呕吐。她通过遮盖任一只眼睛改善了水平复视，以及搏动性耳鸣。她的检查显示完整的单眼视力、轻度双侧外展神经麻痹和轻度至中度双侧视盘水肿（图 1）。她的脑部 MRI 显示眼球后部巩膜轻度变平（图 2）和双侧横静脉窦变窄。眼部相干断层扫描 (OCT) 显示双侧视网膜神经纤维层 (RNFL) 厚度增加至 333 和 356 μm。腰椎穿刺的开口压力为 29 cm H₂ O。