A 15-year-old teenager with refractory intracranial hypertension due to scalp arteriovenous fistula: case report

BackgroundRefractory intracranial hypertension is a condition characterized by persistently elevated intracranial pressure that does not respond to conventional treatments. Diagnosis and management typically involve a combination of medical and surgical interventions. However, identifying the potential etiology can be particularly difficult under certain conditions. The causes of refractory intracranial hypertension due to non-traumatic brain injury are often difficult to detect. Untreated or ineffectively treated refractory intracranial hypertension can result in severe symptoms and potential vision loss.Case presentationWe reported a 15-year-old teenager with no history of trauma who experienced intermittent headaches and projectile vomiting over a 30-day period, accompanied by intracranial pressure exceeding 28 cmH2O. Through clinical reasoning combined with auxiliary examinations, including angiography and ultrasonography, and confirmed by follow-ups after experimental therapy, a final diagnosis of scalp arteriovenous fistula was established.ConclusionsThis case highlights the importance of considering extracranial causes in cases of refractory intracranial hypertension and management strategy for patients with refractory intracranial hypertension.