Difference between revisions of "Idiopathic intracranial hypertension"

Line 20: Line 20:
##can be visualized with [[Ultrasound: Ocular|ultrasound]]
##can be visualized with [[Ultrasound: Ocular|ultrasound]]
#[[Neuro Exam]] frequently normal
#[[Neuro Exam]] frequently normal
##May have cranial nerve palsies in severe, most often CN 6
==Differential Diagnosis==
==Differential Diagnosis==

Revision as of 02:04, 16 February 2016


  • 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. May have cranial nerve palsies in severe, most often CN 6

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