Difference between revisions of "Idiopathic intracranial hypertension"

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#CT scan (negative)
#CT scan (negative)
#[[LP]] (Opening pressure >25)
#[[LP]] (Opening pressure >25)
#MR venogram (to r/o cerebral venous thrombosis)
#MR venogram (to r/o cerebral venous sinus thrombosis)
==Clinical Features==
==Clinical Features==

Revision as of 00:35, 9 February 2015


  • 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


  1. CT scan (negative)
  2. LP (Opening pressure >25)
  3. MR venogram (to r/o cerebral venous sinus thrombosis)

Clinical Features

  1. Headache
  2. Nausea and Vomiting
  3. Vision blurring


  1. Young, obese women
  2. Headache (worse in AM / with manuvers increasing ICP)
  3. Papilledema (optic atrophy/vision loss)
    1. can be visualized with ultrasound
  4. Neuro Exam frequently normal


  1. Aneurysm rupture and Subarachnoid Hemorrhage
  2. Brain tumor
  3. Encephalitis
  4. Head Injury
  5. Hydrocephalus (increased CSF)
  6. Hypertensive brain hemorrhage
  7. Intraventricular hemorrhage
  8. Cerebral venous sinus thrombosis
  9. Meningitis
  10. Subdural Hematoma
  11. Status epilepticus
  12. Stroke


  1. Repeat LPs (decrease CSF pressure)
  2. Acetazolamide 500mg BID
  3. Weight loss
  4. CSF Shunt
  5. Optic nerve sheath fenestration


  • Admit for:
    • Severe pain
    • Focal findings
    • Vision changes
  • Otherwise, discharge w/ ophtho f/u for formal visual field monitoring