Child's Nervous System

, Volume 34, Issue 4, pp 681–690 | Cite as

Secondary intracranial hypertension (pseudotumor cerebri) presenting as post-traumatic headache in mild traumatic brain injury: a case series

  • Tonia SaboEmail author
  • Charlene SupnetEmail author
  • Sushmita PurkayasthaEmail author
Original Paper



Cerebral edema peaks 36–72 h after moderate traumatic brain injury but thought to be uncommon after mild traumatic brain injury. Post-traumatic headache can develop 48–72 h post-injury, perhaps reflecting the developing cerebral edema. Pseudotumor cerebri can result from various causes, including cerebral edema, and is characterized by increased intracranial pressure, headache, visual, and other common symptoms. Our objective was to report a phenotypically identifiable post-traumatic headache subtype.

Case series presentation

This case series of six pediatric patients with post-traumatic pseudotumor cerebri was assessed at 48–120 h post-primary injury with new or a change in symptoms such as headache, vision, auditory, balance, and cognition. Clinical findings included slight fever, neck/head pain, papilledema or cranial nerve deficit (6th), and lack of coordination. Elevated cerebral spinal fluid pressure was documented by lumbar puncture, with no infection. Symptoms improved with treatment specific to post-traumatic headache subtype (lumbar puncture, topiramate, or acetazolamide).


Recognition of specific post-traumatic headache subtypes after mild traumatic brain injury will expedite treatment intervention to lower intracranial pressure and resolve symptoms.


Idiopathic intracranial hypertension Post-traumatic headache Acetazolamide Intracranial pressure Pseudotumor cerebri Concussion 



body mass index


cerebral blood flow


cerebral edema


central nervous system


cerebral spinal fluid


computed tomography


intracranial pressure


idiopathic intracranial hypertension


magnetic resonance imaging


magnetic resonance venography


mild traumatic brain injury


post-concussion symptom


pseudotumor cerebri


post-traumatic pseudotumor cerebri


post-traumatic headache


Authors’ contributions

Tonia Sabo contributed the data for the case presentations, conducted the literature review, and wrote the manuscript. Sushmita Purkayastha contributed to the literature review and the writing of the manuscript. Charlene Supnet contributed to the writing of the manuscript.


This study was not funded by any public, commercial, or not-for-profit entity.

Compliance with ethical standards

Ethics approval and consent to participate

Research described in this case series involving human subjects and data was performed in accordance with the Declaration of Helsinki. This study was reviewed and approved by the University of Texas Southwestern Medical Center Institutional Review Board (STU 092016-046). Consent for the publication of each of the cases and any additional related information, including case details and images, was taken from all the patients/parents of the minors involved in the study.

Conflict of interest

Authors have no financial or non-financial competing interests to report.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of PediatricsUniversity of Texas Southwestern Medical CenterDallasUSA
  2. 2.Children’s Health Children’s Medical CenterDallasUSA
  3. 3.Department of Neurology and NeurotherapeuticsUniversity of Texas Southwestern Medical CenterDallasUSA
  4. 4.Department of Applied Physiology and WellnessSouthern Methodist UniversityDallasUSA

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