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Fever, Headache and Raised Intracranial Pressure

Question:
Anjali Bharani, Pramila Ramawat, Swati Raipurkar
Department of Pediatrics, Index Medical College, Hospital and Research Centre, Indore, Madhya Pradesh, India.

Address for Correspondence: Dr Anjali Bharani, 119, Ravindra Nagar, Indore 452018, Madhya Pradesh, India. Email: dr.anjalibharani@gmail.com

An eleven year old female child presented with fever, headache for 3 days, diplopia for 1 day and tingling, numbness in right lower limb since morning. The headache was predominantly supra-orbital, throbbing in nature affecting left side more than right. There was no history of trauma, seizure, loss of consciousness, earache or vertigo. She had been hospitalized 20 days ago for enteric fever for which intravenous antibiotics were given for 5 days. On examination, she was hemodynamically stable, had no sinus tenderness but had papilledema. On central nervous system (CNS) examination, she had left lateral rectus palsy, brisk deep tendon reflexes on right side with extensor plantar reflex on the same side. Contrast enhanced CT (CECT) head was done (Figure 1).

What is the diagnosis and how to treat it?