Difference between revisions of "Idiopathic intracranial hypertension"

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#Repeat [[LP]]s (decrease CSF pressure)
#Repeat [[LP]]s (decrease CSF pressure)
#[[Acetazolamide]] 500mg BID (decrease CSF production)
#[[Acetazolamide]] 500mg BID (decrease CSF production)
#[[Furosemide]] 20 mg PO BID, give potassium supp as needed
#Weight loss
#Weight loss
#CSF Shunt
#CSF Shunt

Revision as of 14:42, 15 October 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 (decrease CSF production)
  3. Furosemide 20 mg PO BID, give potassium supp as needed
  4. Weight loss
  5. CSF Shunt
  6. Optic nerve sheath fenestration


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