Idiopathic intracranial hypertension

Question 1

Who are most affected by idiopathic intracranial hypertension (IIH) ?

Answer 1

• young obese women

Question 2

What are the clinical features of idiopathic intracranial hypertension (IIH) ?

Answer 2

• headache
• visual disturbances

Question 3

Describe the headache in idiopathic intracranial hypertension (IIH) ?

Answer 3

• non pulsatile
• bilateral
• worse in the morning/ lying down / when bending forwards

Question 4

Describe the opthalmological changes in idiopathic intracranial hypertension (IIH) ?

Answer 4

Transient visual darkening or loss due to optic ischameia.
Will see bilateral papillooedema on fundoscopy.
Can lead to permanent visual loss if untreated.

Question 5

What can be seen on fundoscopy in idiopathic intracranial hypertension (IIH) ?

Answer 5

Bilateral papilloedema

Question 6

What medications are associated with idiopathic intracranial hypertension (IIH) ?

Answer 6

• contraceptive pill
• steroids
• tetracyclines
• vitamin A
• lithium

Question 7

How is idiopathic intracranial hypertension (IIH) investigated?

Answer 7

• BP readings
• brain imaging
• lumbar puncture for opening pressure
• record visual acuity

Question 8

How is idiopathic intracranial hypertension (IIH) managed?

Answer 8

• weight loss
• carbonic anhydrase inhibitor - acetazolamide
• topiramate for headache
• CSF shunting / drainage via lumbar puncture can be considered in severe cases