Difference between revisions of "Idiopathic intracranial hypertension"
| Line 3: | Line 3: | ||
*May be due to impaired arachnoid villi absorption | *May be due to impaired arachnoid villi absorption | ||
*Associated with OCPs, vitamin A, tetracycline, and thyroid disorders | *Associated with OCPs, vitamin A, tetracycline, and thyroid disorders | ||
| + | |||
| + | ==Work-Up== | ||
| + | #CT scan (negative) | ||
| + | #LP (Opening pressure >25) | ||
==Clinical Features== | ==Clinical Features== | ||
| Line 15: | Line 19: | ||
#Neuro exam frequently normal | #Neuro exam frequently normal | ||
| − | == | + | ==DDX== |
| − | # | + | #Aneurysm rupture and subarachnoid hemorrhage |
| − | # | + | #Brain tumor |
| + | #Encephalitis | ||
| + | #Head injury | ||
| + | #Hydrocephalus (increased fluid around the brain) | ||
| + | #Hypertensive brain hemorrhage | ||
| + | #Intraventricular hemorrhage | ||
| + | #Meningitis | ||
| + | #Subdural hematoma | ||
| + | #Status epilepticus | ||
| + | #Stroke | ||
==Treatment== | ==Treatment== | ||
Revision as of 15:22, 22 July 2012
Contents
Background
- Also known as pseudotumor cerebri
- May be due to impaired arachnoid villi absorption
- Associated with OCPs, vitamin A, tetracycline, and thyroid disorders
Work-Up
- CT scan (negative)
- LP (Opening pressure >25)
Clinical Features
- Headache
- N/V
- Vision blurring
Diagnosis
- Young, obese women
- Headache (worse in AM / with manuvers increasing ICP)
- Papilledema (optic atrophy/vision loss)
- Neuro exam frequently normal
DDX
- Aneurysm rupture and subarachnoid hemorrhage
- Brain tumor
- Encephalitis
- Head injury
- Hydrocephalus (increased fluid around the brain)
- Hypertensive brain hemorrhage
- Intraventricular hemorrhage
- Meningitis
- Subdural hematoma
- Status epilepticus
- Stroke
Treatment
- Repeat LPs (decrease CSF pressure)
- Acetazolamide 500mg BID
- Weight loss
- CSF Shunt
- Optic nerve sheath fenestration
Disposition
- Admit for:
- Severe pain
- Focal findings
- Vision changes
- Otherwise, discharge w/ ophtho f/u for formal visual field monitoring
Source
Tintinalli