[TREATMENT DILEMMAS IN FULMINANT INTRACRANIAL HYPERTENSION]

Fulminant intracranial hypertension is a rare, acute presentation of idiopathic intracranial hypertension with rapid and devastating visual loss that can lead to blindness. As vision deteriorates quickly and often irreversibly, prevention of further visual loss requires emergent treatment to decrease intracranial pressure. The case presented is that of an 18 years old male with new symptoms of headaches and visual obscurations that had rapid progressive visual loss with findings of severe bilateral swollen discs. Brain MRI and MRV ruled out intracranial mass and cerebral venous thrombosis. A lumbar puncture confirmed highly increased ICP. Due to the fulminant clinical presentation, he underwent an urgent fenestration of both optic nerves with improvement of vision in both eyes. The patient's clinical scenario accentuates the importance of prompt recognition of this rare disorder and the need for immediate surgical intervention to prevent further visual loss and blindness.