idiopathic intracranial htn

Question 1

define

Answer 1

Idiopathic intracranial hypertension (also known as pseudotumour cerebri and formerly benign intracranial hypertension) is a condition classically seen in young, overweight females.

Question 2

Risk factors

Answer 2

• obesity
• female sex
• pregnancy
• drugs*: oral contraceptive pill, steroids, tetracycline, vitamin A, lithium

*if intracranial hypertension is thought to occur secondary to a known causes (e.g. Medication) then it is of course not idiopathic

Question 3

s/s

Answer 3

• As if SOL – no mass
• Headache
• Papilloedema
• Visual
• Blurred vision
• 6th CN palsy± diplopia
• Enlarged blind spot

consciousness and cognition preserved

Question 4

Management

Answer 4

• weight loss
• diuretics e.g. acetazolamide
• topiramate is also used, and has the added benefit of causing weight loss in most patients
• Prednisolone – may reverse papilloedema
• surgery:
  
  • Lumbar-peritoneal shunt may be necessary if drugs fail and visual loss deteriorates
  • optic nerve sheath decompression and fenestration may be needed to prevent damage to the optic nerve.
  • A lumboperitoneal or ventriculoperitoneal shunt may also be performed to reduce intracranial pressure