DR. MAYUR MOREKER

Abstract

A 35-year-old lady presented with headache; for 35 days; diminution of vision 5 days after headache in OU; being treated elsewhere for idiopathic intracranial hypertension; with documented high opening pressures from multiple lumbar punctures. She had perception of light with accurate projection of rays; with swollen mildly hyperemic optic nerves and peripapillary haemorrhage with occasional telltale vitreous cells in OU

Lumbar puncture showed an opening pressure of 180 cm of H20. On further enquiry; this lady was positive for blood RPR; prior to the onset of her current symptoms. We repeated a Blood TPHA and CSF analysis with TPHA; both of which were positive. Patient was treated as Neurosyphilis; to achieve resolution of symptoms and disc odema in OU; at 2 months

This report describes an extremely infrequent case of bilateral secondary intracranial hypertension with papillodema and peripapillary haemorrhage as a presenting feature of neurosyphilis in an immunocompetent young lady