Abstracto

Idiopathic intracranial hypertension could be mere a chronic active bacterial encephalitis.

Abbas Alnaji

Over more than fifteen years of my Career in Neurosurgery I focused my efforts on the causation of surgical pathologies (biological bases). Idiopathic intracranial hypertension is embarrassing, that whatever the neurosurgeon does, still some end with big disability, the blindness. My vision is based on two, first, as the histopathology of brain parenchyma say presence of long standing water in extracellular spaces without trauma or toxins, the logic explanation for that is the chronic inflammatory process. The second base, I concentrated on the patient as a whole rather than on CNS only trying to discover the relation between this CNS inflammatory process and presence of any systemic disease which make this CNS impairment as a complication to it. By taking a strict history, systemic review and physical examination I concluded the presence of a chronic or sub-acute general disease which in my career it was chronic Brucellosis however (pre- PCR era in Iraq) serology is negative in most, for that anti Brucella trial treatment was adopted to result in a very high success rate in mild to moderate cases which are several tens in number, three severe cases who end with blindness then regained their full vision over the last ten years. Complete work up done to exclude other entities, fundus camera to register and follow optic disc edema or atrophy.