Pseudotumor cerebri induced by topical application of steroid: a case report.

A 19-year-old man visited the neurology clinic for evaluation of a headache and pulsating tinnitus that he had experienced for 2 months. A neurological examination was normal, except for bilateral disc swelling. His medical history was notable for recently diagnosed psoriasis for which he had been applying topical hydrocortisone 2.5% three to four times a day. Neuro-imaging with a computed tomography scan and magnetic resonance imaging/magnetic resonance venography of the brain was normal, except for tortuosity of the optic nerves and dilatation of the optic nerve sheaths. Pseudotumor cerebri was suspected. Unfortunately, the patient refused a spinal tap to measure the cerebrospinal fluid opening pressure. Excessive application of topical steroid was believed to be the cause of the patient’s pseudotumor cerebri . The patient’s headache and disc swelling improved after treatment with and cessation of topical hydrocortisone. This is the first case report of a topical steroid associated with pseudotumor cerebri