Idiopathic Intracranial Hypertension in a Non-obese Male Patient: A Case Report

Idiopathic intracranial hypertension (IIH) is a disorder characterized by elevated intracranial pressure without an identifiable structural or secondary cause and is classically seen in obese women of childbearing age. We report a case of a 34-year-old non-obese male patient who presented with a six-month history of progressively worsening daily headaches, transient visual obscurations, and intermittent pulsatile tinnitus. Neurological examination revealed bilateral papilledema with preserved visual acuity, while laboratory investigations were unremarkable. Neuroimaging with computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated features suggestive of raised intracranial pressure, including partial empty sella, posterior globe flattening, perioptic subarachnoid space distension, and optic nerve tortuosity, without evidence of mass lesion or venous sinus thrombosis. Lumbar puncture confirmed an elevated opening pressure of 32 cm H₂O with normal cerebrospinal fluid composition. A diagnosis of IIH was established after exclusion of secondary causes. The patient was managed conservatively with acetazolamide and symptomatic therapy, resulting in significant improvement in headache frequency and resolution of visual disturbances over three months, with stabilization of visual fields. This case highlights that IIH can occur in atypical populations, including non-obese men, and underscores the importance of early recognition, comprehensive evaluation, and timely intervention to prevent visual morbidity.