Difference between revisions of "Idiopathic intracranial hypertension"

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#[[Neuro Exam]] frequently normal
#[[Neuro Exam]] frequently normal
==Differential Diagnosis==
#Aneurysm rupture and [[Subarachnoid Hemorrhage]]
*Aneurysm rupture and [[Subarachnoid Hemorrhage]]
#Brain tumor
*Brain tumor
#[[Head Injury]]
*[[Head Injury]]
#Hydrocephalus (increased CSF)
*Hydrocephalus (increased CSF)
#Hypertensive brain hemorrhage
*Hypertensive brain hemorrhage
#Intraventricular hemorrhage
*Intraventricular hemorrhage
#Cerebral venous sinus thrombosis
*Cerebral venous sinus thrombosis
#[[Subdural Hematoma]]
*[[Subdural Hematoma]]
#Status epilepticus
*Status epilepticus

Revision as of 05:02, 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

Differential Diagnosis


  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