The Pressure Behind the Eyes

A 25-year-old woman with obesity presents with headaches and blurred vision. Discover the key diagnostic finding for idiopathic intracranial Hypertension.

Elevated opening pressure


A 25-year-old woman with severe obesity presented to the emergency department with a 1-week history of blurred vision, headaches, and transient visual obscurations. Neurologic examination showed optic disk swelling and retinal hemorrhages in both eyes. An MRI and MRV of the head showed flattened posterior globes, an empty sella, and stenoses of the transverse sinuses without obstruction or thromboses. Which abnormality would most likely be notable from a lumbar puncture?

What is the most likely diagnosis?

Elevated opening pressure
Elevated white blood cell count
Oligoclonal bands
Positive anti-aquaporin 4 antibody
Xanthochromia

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