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Conditions we treat

Idiopathic Intracranial Hypertension

What is idiopathic intracranial hypertension?

Idiopathic Intracranial Hypertension (IIH) is a syndrome with signs and symptoms of increased intracranial pressure but where a causative mass or hydrocephalus is not identified. Adult women of childbearing age are more likely to develop idiopathic intracranial hypertension. It also has a strong association with obesity.

What causes idiopathic intracranial hypertension?

The cause of IIH is essentially unknown and poorly understood. Suggested mechanisms include decreased cerebral spinal fluid (CSF) absorption, increased CSF production, increased intravascular volume, increased intracranial venous pressure and hormonal changes.

Symptoms?

Symptoms include:

  • High-pressure headache
  • Changes in eyesight such as blurry vision, double vision, or reduced vision
  • Nausea and vomiting
  • Tinnitus

Diagnosis/Investigations

If these symptoms are present, a CT or MRI scan may be ordered to investigate and rule out other potential causes of increased intracranial pressure. A lumbar puncture is necessary to measure the cerebral spinal fluid pressure. A needle is inserted into the lumbar spine to collect CSF and the fluid is then sent for testing. The removal of CSF may alleviate symptoms for a short period, though when the fluid reaccumulates symptoms will return if idiopathic intracranial hypertension is the cause of the symptoms.

Treatment Options:

Treatment options for idiopathic intracranial hypertension include:

  1. CSF letting
  2. Medical therapy – acetazolamide
  3. Lumboperitoneal shunt
  4. Optic nerve fenestration
  5. Dural venous sinus stenting

References

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