Following a routine immunisation a 9 month old child developed vomiting and drowsiness. On examination there was bulging of anterior fontanelle. Fundoscopy revealed papilledema. The child developed cranial nerve palsies within a few hours. Inspite of all these findings the child was afebrile with clear chest. What is the MOST probable diagnosis?
The condition described here is pseudotumor cerebri. Along with the vaccination the child may have received a bolus dose of Vit A which might have precipitated the toxicity. In meningitis the child is usually febrile. In astrocytoma the progression occurs gradually. Ref: Nelson, Edition 17, Page - 180.
Meningitis
Sagittal sinus thrombosis
Vit A toxicity
Astrocytoma