Idiopathic intracranial hypertension

Background

Impaired arachnoid villi absorption

Diagnosis

1. Young, obese females
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. Diamox
3. Weight loss
4. Shunt
5. Optic nerve sheath fenestration

Disposition

Admit for:

1. Severe pain
2. Focal findings
3. Vision changes