Idiopathic Intracranial HTN

Question 1

Give 4 risk factors for Idiopathic Intracranial Hypertension

Answer 1

obesity
female
pregnancy
drugs

Question 2

Name 5 drugs/ classes associated with Idiopathic Intracranial Hypertension

Answer 2

COCP
Steroids
Tetracyclines
Retinoids (isotretinoin, tretinoin) / vitamin A
Lithium

Question 3

Give 4 symptoms of Idiopathic Intracranial Hypertension

Answer 3

Headache
Blurred vision
Pulsatile tinnitus
6th nerve palsy: diplopia

Question 4

Give 2 signs of IIH on examination

Answer 4

Bilateral Papilloedema
Enlarged blind spot
Peripheral loss of vision

Question 5

What investigations are performed in IIH?

Answer 5

CT/ MRI head to r/o ddx
Definitive diagnosis: LP with elevated opening pressure

Question 6

What general measures can be used to treat IIH?

Answer 6

Weight loss
Stop causative agent

Question 7

Describe the medical management of IIH

Answer 7

Acetazolamide: carbonic anhydrase inhibitor- reduces production of CSF
or
Topiramate: weight loss, treats migraine + inhibits carbonic anhydrase

Both reduce pressure on optic nerve

Question 8

Describe surgical management of IIH

Answer 8

Optic nerve sheath fenestration + decompression

CSH Shunting (lumboperitoneal or ventriculoperitoneal reduces ICP)