Difference between revisions of "Idiopathic intracranial hypertension"

Line 3: Line 3:
 
*May be due to impaired arachnoid villi absorption
 
*May be due to impaired arachnoid villi absorption
 
*Associated with OCPs, vitamin A, tetracycline, and thyroid disorders
 
*Associated with OCPs, vitamin A, tetracycline, and thyroid disorders
 +
 +
==Clinical Features==
 +
#Headache
 +
#N/V
 +
#Vision blurring
  
 
==Diagnosis==
 
==Diagnosis==
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==Work-Up==
 
==Work-Up==
 
#CT scan (negative)
 
#CT scan (negative)
#LP (CSF pressure 25-40)  
+
#LP (Opening pressure >25)  
  
 
==Treatment==
 
==Treatment==
#Repeate LPs (decrease CSF pressure)
+
#Repeat LPs (decrease CSF pressure)
#Acetazolamide 250mg BID
+
#Acetazolamide 500mg BID
 
#Weight loss
 
#Weight loss
 
#CSF Shunt
 
#CSF Shunt
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**Focal findings
 
**Focal findings
 
**Vision changes
 
**Vision changes
 +
*Otherwise, discharge w/ ophtho f/u for formal visual field monitoring
  
 
==Source==
 
==Source==

Revision as of 21:20, 29 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

Clinical Features

  1. Headache
  2. N/V
  3. Vision blurring

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 (Opening pressure >25)

Treatment

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

Disposition

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

Source

Tintinalli