Idiopathic intracranial hypertension

Revision as of 05:01, 1 October 2011 by Jswartz (talk | contribs)

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