Iranian Journal of Medical Sciences
Iranian Journal of Medical Sciences

Approach to Chronic Secondary Headache: A Case report on Unusual Drug Side Effects

Document Type : Case Report(s)

Authors

Hamid Reza Riasi 1
Forod Salehi 2
Morteza Hajihosseini 3

1 Department of Neurology, Birjand University of Medical Sciences, Birjand, Iran

2 Atherosclerosis and Coronary Artery Research Center, Department of Pediatric Cardiology, Birjand University of Medical Sciences, Birjand, Iran

3 Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences, Birjand, Iran

Abstract
In this article, we present the case of a 12-year-old female child who complained of bilateral temporal and frontal headache for 2 to 3 months with nausea and vomiting. Physical examination revealed right-sided sixth cranial nerve palsy and papilledema in ophthalmoscopy. To find the cause of increased intracranial pressure, the patient underwent brain imaging and brain MRI showed no abnormality. Ultimately, lumbar puncture (LP) was performed and cerebrospinal fluid (CSF) pressure was 280 mmH2O with normal chemistry.We considered pseudotumor cerebri as the first diagnosis. LP was carried out three times and 30cc of CSF was tapped each time. Finally, patient's headache and papilledema improved and physical examination after 6 months showed no sign of raised intracranial pressure (rICP). The most prominent point in her past medical history was the use of growth hormone (GH) for 2 years. No sign of symptom relapse has been seen after 6 months of drug discontinuation.We must consider the hazard of growth hormone as a potential cause of increased intracranial pressure. When the use of GH is justified, the follow-up must include an ophthalmoscopy examination in each session.

Keywords

Child
Growth hormone
Vomiting
Headache
Iranian Journal of Medical Sciences
Volume 42, Issue 6 - Serial Number 6
89
November 2017
Pages 611-614

  • Received 08 June 2016
  • Accepted 24 December 2018

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