Difference between revisions of "Idiopathic intracranial hypertension"

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*CT scan (negative or slit-like ventricles)
*CT scan (negative or slit-like ventricles)
*[[LP]] (Opening pressure >25)
*[[LP]] (Opening pressure >25)
*MR venogram (to rule out cerebral venous sinus thrombosis)
*CT or MR venogram (to rule out [[cerebral venous sinus thrombosis]])

Revision as of 20:08, 20 March 2017


  • Also known as pseudotumor cerebri/benign intracranial hypertension (BIH)
  • Cause is idiopathic, but believed be due to impaired CSF absorption at arachnoid villi
  • Associated with OCPs, vitamin A, tetracycline and thyroid disorders

Clinical Features

Differential Diagnosis


  • Young, obese women
  • Headache (worse in AM / with manuvers increasing ICP)
  • Papilledema (optic atrophy/vision loss)
  • Neuro Exam frequently normal
    • May have cranial nerve palsies in severe, most often CN 6



  • Repeat LPs (decrease CSF pressure) - large volume LPs on the order of 30-40 cc of CSF
  • Acetazolamide 500mg BID (decrease CSF production)
  • Furosemide 20mg PO BID, give potassium supp as needed
  • Weight loss
  • CSF Shunt
  • Optic nerve sheath fenestration


  • Admit for:
    • Severe pain
    • Focal findings
    • Vision changes
  • Otherwise, discharge with ophtho follow up for formal visual field monitoring

External Links

See Also