A 25 year old woman was referred with a history of chronic headache for a period of three months. The headache was severe and refractory to NSAIDs or other pain relievers. There was no history of chills and fever, gait disturbance, hearing loss and memory problems. No history of using illicit drugs such as cocaine, alcohol, cannabis was also found. Drug history was negative for oral contraceptive pills, nalidoxic acid, tetracycline, corticosteroids, vitamin A and other drugs. She was student, lived in an urban area with history of travels to rural areas. No history of using unpasteurized milk and contact with animals were found. 
 In physical examination, vital signs were normal. Generally, she was cooperative with intact orientation. Cranial nerve examinations were normal and meningeal signs were not detected. There was a significant papilledema in ophthalmologic examination. Deep tendon reflexes (DTRs) in upper and lower limbs were normal. Muscle forces in proximal and distal regions of lower and upper limbs were also normal. No impairment in the sensation of extremities was detected. Gait was intact with no ataxia and tremor. Psychological examination was also done. There was not any abnormality in mood and affect evaluation and no cognitive impairment was also observed. 
 Laboratory studies including complete blood count with differentiation (CBC/ diff), prothrombin time (PT), partial thromboplastin time (PTT), international normalized ratio (INR), blood urea nitrogen, creatinine (BUN,Cr) and liver function tests (LFT) were normal. An elevated ESR was detected (68mm/hour). HBS Ag, HCV Ab, VDRL and HIV Ab were also negative. Anti-nuclear antibody (ANA), Anti-neutrophil cytoplasmic antibodies (ANCA), C3 and C4 were in normal range. Brain CT scan in addition to T1 and T2 weighted brain MRI plains after gadolinium injections were also performed that revealed no pathologic findings. The patient underwent lumbar puncture. Cerebrospinal fluid appeared xanthochromic and presented with a high opening pressure (280 mmH2O), low glucose (43mg/dl) and elevated protein levels (338mg/dl). Spinal fluid analysis showed leukocytes. Brucella (capt test) tube agglutinin was positive at 1/2560 titers in blood and positive at spot and 1/2560 titers in CSF. Tuberculosis PCR test was negative for the CSF sample. 
 In summary, we had a case with a history of chronic headache characterized by increased intra-cranial pressure (ICP). Papilledema was the only positive finding in the initial physical examination. SAT (serum antibody test) was the only positive finding for brucella within the laboratory test. Other investigations including imaging studies were normal. The patient received intravenous cefteriaxone 1gr BID and oral doxycycline 100mg BID and rifampin 600 mg once daily for 1 month; and then rifampin continued for 14 months. Headache began to improve during treatment and disappeared after 3 months.