Difference between revisions of "Idiopathic intracranial hypertension"

(Background)
Line 1: Line 1:
 
==Background==
 
==Background==
*Impaired arachnoid villi absorption
+
*Also known as pseudotumor cerebri
*Also known as "Pseudotumor cerebri (PTC)" or "Benign intracranial hypertension (BIH)"
+
*May be due to impaired arachnoid villi absorption
 +
*Associated with OCPs, vitamin A, tetracycline, and thyroid disorders
  
 
==Diagnosis==
 
==Diagnosis==
#Young, obese females
+
#Young, obese women
#Headache (worse in AM/ with manuvers increasing ICP)
+
#Headache (worse in AM / with manuvers increasing ICP)
 
#Papilledema (optic atrophy/vision loss)
 
#Papilledema (optic atrophy/vision loss)
 
#Neuro exam frequently normal  
 
#Neuro exam frequently normal  
  
 
==Work-Up==
 
==Work-Up==
# CT scan (negative)
+
#CT scan (negative)
# LP (CSF pressure 25-40)  
+
#LP (CSF pressure 25-40)  
  
 
==Treatment==
 
==Treatment==
# Repeate LPs (decrease CSF pressure)
+
#Repeate LPs (decrease CSF pressure)
# Diamox
+
#Acetazolamide 250mg BID
# Weight loss
+
#Weight loss
# Shunt
+
#CSF Shunt
# Optic nerve sheath fenestration  
+
#Optic nerve sheath fenestration  
  
 
==Disposition==
 
==Disposition==
Admit for:
+
*Admit for:
# Severe pain
+
**Severe pain
# Focal findings
+
**Focal findings
# Vision changes
+
**Vision changes
 +
 
 +
==Source==
 +
Tintinalli
  
 
[[Category:Neuro]]
 
[[Category:Neuro]]

Revision as of 05:01, 1 October 2011

Background

  • Also known as pseudotumor cerebri
  • May be due to impaired arachnoid villi absorption
  • Associated with OCPs, vitamin A, tetracycline, and thyroid disorders

Diagnosis

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

Work-Up

  1. CT scan (negative)
  2. LP (CSF pressure 25-40)

Treatment

  1. Repeate LPs (decrease CSF pressure)
  2. Acetazolamide 250mg BID
  3. Weight loss
  4. CSF Shunt
  5. Optic nerve sheath fenestration

Disposition

  • Admit for:
    • Severe pain
    • Focal findings
    • Vision changes

Source

Tintinalli