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Jess BoxleyBritish medical student with intracranial hypertension
Country:
 Great Britain |
Content:
- A Medical Student's Nightmare: Intracranial Hypertension
- The Hidden Danger of "Brain Freeze"
- Deteriorating Symptoms and Blurred Vision
- Diagnosis of Intracranial Hypertension (IH)
- Rapid Progression and Hospitalization
- Emergency Eye Examination and Prompt Treatment
- "I was petrified because I had no idea what was wrong with me."
- In Bocxley's case, doctors were unable to establish an exact cause.
- Recovery and Ongoing Monitoring
- Importance of Eye Exams
- Optometrist's Perspective
- Potential Causes of Chronic IH
- - Venous sinus thrombosis—a blood clot in one of the brain's veins
- - Being overweight or obese (more common in women)
- - Chronic kidney disease
A Medical Student's Nightmare: Intracranial Hypertension
Misdiagnosed Migraines Almost Cost Her SightBritish medical student Jess Bocxley initially dismissed her persistent headaches as mere drafts in her bedroom. However, she later discovered that she was suffering from a rare brain condition that nearly robbed her of her eyesight.
The Hidden Danger of "Brain Freeze"
Bocxley, now 22, initially attributed her migraines to the low temperatures in her bedroom, which she referred to as "brain freeze." Little did she know that she might have been experiencing what is medically known as "cold-induced pain," sometimes called "ice cream headaches."
Deteriorating Symptoms and Blurred Vision
Despite taking paracetamol, Bocxley's condition worsened, and she began experiencing nausea and eye pain. She soon realized she was losing her vision.
Diagnosis of Intracranial Hypertension (IH)
The Tipton, West Midlands resident was unaware that she was suffering from intracranial hypertension (IH), a condition caused by excess fluid building up around the brain. If left untreated, IH, which predominantly affects women in their 20s and 30s, can lead to permanent vision loss in one in every five to 20 cases.
"My vision would go black for about 10 seconds at a time, and I couldn't see anything," Bocxley recalled. "I joked to my mom that I was going blind. But it just got worse over the next couple of days."
"The pain started going into my neck. I put it down to sleeping in an awkward position or being in a draft. But then I started getting these really intense headaches, like migraines," she continued. "I was taking paracetamol round the clock, but it wasn't touching it."
Rapid Progression and Hospitalization
In October 2016, Bocxley's symptoms intensified. Her left eye became excruciatingly painful, and her vision continued to deteriorate.
Soon, the pain spread throughout her head and neck. As a nursing student at Birmingham City University, Bocxley struggled to stay awake and concentrate, often missing classes due to the unbearable pain.
"The headaches were horrific. It felt like my head was going to explode. I started going to bed at 8 p.m. every night just to avoid the pain," she said.
"But that didn't work, because I'd wake up in the middle of the night and not be able to get back to sleep. That's when I knew something was really wrong," she added.
Emergency Eye Examination and Prompt Treatment
Bocxley visited her GP, who referred her to an eye specialist immediately.
"I went to the opticians and just said, 'There's something wrong with me,'" Bocxley said. "The optician did some really basic tests and took a picture of the back of my eye."
The patient was rushed to the eye casualty department at Birmingham City Hospital and then straight to the emergency room.
"They put me straight in the back of an ambulance and blue-lighted me to the resuscitation department," Bocxley recalled. "They said that it wasn't safe for me to even walk that short distance."
"That's when I felt really ill. My head was pounding, and my heart was racing," she added.
"I was petrified because I had no idea what was wrong with me."
Diagnosis and TreatmentBocxley underwent a CT scan and a series of lumbar punctures, procedures in which a needle is inserted into the lower spine to drain excess fluid from the brain and relieve pressure.
The neurologist explained that Bocxley had intracranial hypertension, which can appear suddenly as a result of a severe head injury, brain tumor, stroke, or brain abscess.
In Bocxley's case, doctors were unable to establish an exact cause.
"They said I had swelling of the optic nerve, and the IH was causing pressure, which can cause headaches, vision loss, blackouts, and sickness—just like I was experiencing," she said.
"I did some research and found out that IH can be life-threatening if left untreated."
"I was in complete shock. I knew the headaches were bad, but I never thought they could be linked to something so serious in my brain," she added.
Recovery and Ongoing Monitoring
Bocxley spent five days in the hospital. The lumbar punctures were deemed successful, and she was discharged.
She now attends monthly check-ups, as intracranial hypertension can become a chronic condition. However, this is less common, and there is limited research available.
Importance of Eye Exams
Essentially, Bocxley saved her own life and vision by visiting an optometrist.
"It makes me realize how important it is to get your eyes tested regularly. The eye test literally saved my sight," she said.
Optometrist's Perspective
Ghussnan Ejaz, the Specsavers optometrist in Dudley who treated Bocxley, said: "After carrying out a series of routine tests, and using a digital retinal camera to look at the back of the eye, I could immediately see that there was something seriously wrong with Jessica's optic nerve."
"I found severe swelling, which could have been life-threatening if left unchecked."
"Jessica's case highlights the value of eye tests for everyone, regardless of age," he added. "We're delighted that we were able to help Jessica. Her case is quite rare, but they do happen, so it's important that people don't neglect their eye health. And opticians are able to detect a wide range of conditions during an eye examination."
"If you have any unusual symptoms, don't delay—contact your optician and get your eyes checked immediately," he advised.
Potential Causes of Chronic IH
- Chronic subdural hematoma—a blood clot on the surface of the brain- Brain tumor
- Infection of the brain, such as meningitis or encephalitis
- Hydrocephalus—a buildup of fluid around and inside the brain
- Blood vessel malfunctions, such as an arteriovenous fistula or an arteriovenous malformation
- Venous sinus thrombosis—a blood clot in one of the brain's veins
In many cases, the cause of chronic IH remains unknown. However, it has been linked to:
- Being overweight or obese (more common in women)
- Hormonal problems, such as Cushing's syndrome, hypoparathyroidism, an underactive thyroid gland, or an overactive thyroid gland
- Taking certain medications, including some antibiotics, steroids, and contraceptive pills
- Having a shortage of red blood cells (iron deficiency anemia) or having too many red blood cells (polycythemia vera)
