# Idiopathic intracranial hypertension | Symptoms, Causes, Tests and Treatment | OSANG > Idiopathic intracranial hypertension is a disease in which intracranial pressure rises without an obvious cause such as a tumor or vascular lesion, and is also called ps… - Official page: https://osns.co.kr/en/encyclopedia/idiopathic-intracranial-hypertension - Organization: OSANG Neurosurgery ## Page content Headache ## Idiopathic intracranial hypertension Idiopathic Intracranial Hypertension · G93.2 Idiopathic intracranial hypertension is a disease in which intracranial pressure rises without a clear cause. It occurs most often in obese women of childbearing age and, if left untreated, can lead to permanent vision damage due to papilledema. ## At a glance Idiopathic intracranial hypertension is a disease in which intracranial pressure rises without an obvious cause such as a tumor or vascular lesion, and is also called pseudotumor cerebri. It occurs most often in obese women of childbearing age and, if not treated, there is a risk of permanent vision damage due to papilledema. The diagnosis is based on papilledema, normal brain imaging, and elevated cerebrospinal fluid opening pressure (>25 cmH2O in adults) on lumbar puncture. There is a randomized study showing that acetazolamide and weight loss improved visual field in patients with mild vision loss. - 01Definition and Overview - 02Epidemiology - 03symptoms - 04diagnosis - 05treatment - 06Clinical implications ## Definition and Overview Idiopathic intracranial hypertension (IIH) is a disease in which intracranial pressure rises without an obvious structural cause, such as tumor, hydrocephalus, or venous sinus thrombosis. It is also called pseudotumor cerebri because intracranial pressure rises even though there is no tumor, causing symptoms similar to a tumor. If left untreated, papilledema can lead to permanent vision loss. ## Epidemiology It occurs more frequently in obese women of childbearing age. Obesity and weight gain are major risk factors, and some medications have also been reported as triggers. It can also occur in men and children, but less frequently. ## symptoms Chronic headaches are the most common symptom and often persist to the point that they interfere with daily life. It may be accompanied by pulsatile tinnitus, where sounds are heard in time with the heartbeat, transient visual blurring where vision becomes blurred for a few seconds, and double vision due to abducens nerve paralysis. Damage to visual function first appears as a defect in peripheral vision, and as it progresses, it leads to permanent vision loss. ## diagnosis Diagnosis is based on revised diagnostic criteria incorporating the following factors: - Papilloedema: A fundus examination confirms swelling of the optic nerve head. - Brain imaging: There must be no tumor, hydrocephalus, venous sinus thrombosis, etc. that could explain the increased intracranial pressure on MRI. - Lumbar puncture: Cerebrospinal fluid opening pressure exceeds 25 cmH2O for adults. - Cerebrospinal fluid composition: cell number and protein are normal. Visual field testing is essential for diagnosis and follow-up, and quantitatively evaluates the degree of damage to visual function. ## treatment Weight loss is the key to fundamental treatment. Acetazolamide, a carbonic anhydrase inhibitor, is used to lower intracranial pressure. In a randomized controlled trial (IIHTT) targeting patients with mild vision loss, the group that received acetazolamide and weight loss had greater improvement in visual field. In severely ill patients with rapidly progressing visual impairment, surgical treatments such as optic nerve sheath decompression, cerebrospinal fluid shunt, and venous sinus stent insertion are considered. ## Clinical implications Idiopathic intracranial hypertension should be suspected when chronic headache is accompanied by pulsatile tinnitus and transient visual blur, and papilledema is confirmed on fundus examination. Since preserving visual function is the top goal of treatment, early diagnosis and regular visual field tracking are important. ## Frequently asked questions ### Q01Who is most likely to develop idiopathic intracranial hypertension? It occurs most commonly in obese women of childbearing age. Weight gain is known to increase risk, and some medications have also been reported as triggers. The name pseudotumor comes from the fact that intracranial pressure rises like a tumor even though there is no tumor. ### Q02What symptoms do you experience? Chronic headaches are the most common symptom, and pulsatile tinnitus that is heard in time with the heartbeat, temporary blurred vision, and double vision, where objects appear as two, may also occur. If left untreated, papilledema can gradually cause vision loss. ### Q03Why is papilledema dangerous? Papilledema is a condition in which the optic nerve head swells due to increased intracranial pressure. If it persists for a long time, the optic nerve can be damaged, narrowing the field of vision and progressing to permanent vision damage. Therefore, after diagnosis, visual function is regularly tracked with visual field tests. ### Q04How is it diagnosed? A fundus examination confirms papilledema, and a brain MRI confirms that there are no other causes, such as a tumor or venous sinus thrombosis. The diagnosis is made when the cerebrospinal fluid opening pressure in a lumbar puncture exceeds 25 cmH2O (standard for adults) and the cerebrospinal fluid composition is normal. ### Q05How is it treated? Weight loss is the basic treatment, and acetazolamide, a drug that lowers intracranial pressure, is used. There is a randomized study showing that acetazolamide and weight loss improved visual field in patients with mild vision loss. In severe cases where visual impairment progresses, optic nerve sheath decompression or shunt surgery is considered. ## Related articles - giant cell arteritis - Hemicrania continua - Hypnic Headache - paroxysmal hemicrania This article provides general medical information and does not replace an individual diagnosis or treatment plan. Please seek a medical assessment if symptoms persist. ## Important notice This Markdown alternative helps search and AI tools understand the public page accurately. It provides general health information and does not replace an individual diagnosis or treatment.