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== | ||
| Line 12: | Line 17: | ||
==Work-Up== | ==Work-Up== | ||
#CT scan (negative) | #CT scan (negative) | ||
| − | #LP ( | + | #LP (Opening pressure >25) |
==Treatment== | ==Treatment== | ||
| − | # | + | #Repeat LPs (decrease CSF pressure) |
| − | #Acetazolamide | + | #Acetazolamide 500mg BID |
#Weight loss | #Weight loss | ||
#CSF Shunt | #CSF Shunt | ||
| Line 26: | Line 31: | ||
**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
- Headache
- N/V
- Vision blurring
Diagnosis
- Young, obese women
- Headache (worse in AM / with manuvers increasing ICP)
- Papilledema (optic atrophy/vision loss)
- Neuro exam frequently normal
Work-Up
- CT scan (negative)
- LP (Opening pressure >25)
Treatment
- Repeat LPs (decrease CSF pressure)
- Acetazolamide 500mg BID
- Weight loss
- CSF Shunt
- 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