en Neurology Neurology case report case report <span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="color:#0000ff;"><strong><em>Background</em></strong><em>:</em></span> Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune astrocytopathic disease affecting central nervous system (CNS). CSF pressure in these patients is usually normal.<br> <span style="color:#0000ff;"><strong><em>Case Presentation</em></strong><em>:</em> </span>A 30-year-old woman was admitted with complaints of headache and lower limbs paresis. Lumbar puncture (LP) and magnetic resonance imaging were performed for the patient. Opening pressure was 42 cm H2O in the first LP. According to the clinical evidences, imaging, and the patient&#39;s positive aquaporin-4 antibody, the diagnosis of NMOSD was established.<br> <span style="color:#0000ff;"><strong><em>Conclusion</em></strong><em>:</em> </span>High intracranial pressure headache; however rare, may be the first sign of the onset of the acute exacerbation phase of NMOSD.</span></span> <pre> </pre> NMOSD, High ICP, Anti- aquaporin antibody 435 438 http://caspjim.com/browse.php?a_code=A-10-646-8&slc_lang=en&sid=1 Seyed Mohammad Forouzannia Mmd.forouzan@gmail.com 100319475328460031214 100319475328460031214 No Multiple sclerosis research center, Neuroscience institute, Tehran University of medical sciences, Tehran, Iran. Pourya Yarahmadi Pourya.yarahmadi@gmail.com 100319475328460031215 100319475328460031215 No Multiple sclerosis research center, Neuroscience institute, Tehran University of medical sciences, Tehran, Iran. Mohammad Alirezaei m.alirezaei77@gmail.com 100319475328460031216 100319475328460031216 No Multiple sclerosis research center, Neuroscience institute, Tehran University of medical sciences, Tehran, Iran. Nasim Rezaeimanesh rezaeimaneshnasim@gmail.com 100319475328460031217 100319475328460031217 No Multiple sclerosis research center, Neuroscience institute, Tehran University of medical sciences, Tehran, Iran. Abdorreza Naser Moghadasi abdorrezamoghadasi@gmail.com 100319475328460031218 100319475328460031218 Yes Multiple sclerosis research center, Neuroscience institute, Tehran University of medical sciences, Tehran, Iran.