Idiopathic intracranial hypertension
From Standard of Care
Secondary to increased venous sinus pressure.
Predilection for young women who are likely to be obese.
Chronic daily headaches, normal neurological examination (except for papilledema) and normal lab examination (except for an empty sella).
May have a severe lateralizing pulsatile headache, with intracranial noises, double vision, and nausea.
Unremitting headaches with episodic worsening, accompanied by pulsatile tinnitus, transient visual difficulties and diplopia may occur.
Visual acuity is preserved until late in the course of the illness.
Bilateral optic disc edema is often present.
The CSF has an opening pressure of greater than 25 cm of water, and the CSF is normal.
Neuroimaging includes a normal brain MRI.
Treatment includes weight reduction, surgical treatment with either lumbar to peritoneal shunting, or fenestration of the optic nerve sheath, and lowering of intracranial pressure with acetazolamide.