Idiopathic intracranial hypertension

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