Idiopathic intracranial hypertension

Question 1

Idiopathic intracranial hypertension commonly seen in ?

Answer 1

young, overweight females.
pregnancy

Question 2

what drugs can cause idiopathic intracranial hypertension ?

Answer 2

combined oral contraceptive pill
steroids
tetracyclines - doxycyclines
retinoids (isotretinoin, tretinoin) / vitamin A
lithium

Question 3

features of idiopathic intracranial hypertension ?

Answer 3

headache
blurred vision
papilloedema (usually present)
enlarged blind spot
sixth nerve palsy may be present (abducts the eye)

Question 4

management of idiopathic intracranial hypertension ?

Answer 4

weight loss

start semaglutide (glp-1 agonist ) and topiramate considered by specialists

carbonic anhydrase inhibitors e.g. acetazolamide

repeated lumbar puncture - temporary measure but is not suitable for longer-term management

A lumboperitoneal or ventriculoperitoneal shunt may also be performed to reduce intracranial pressure

Question 5

why is topimarate specially useful

Answer 5

also inhibits carbonic anhydrase

added benefit of causing weight loss in most patients

Question 6

what type of surgery may prevent visual field loss in idiopathic intracranial hypertension ?

Answer 6

optic nerve sheath decompression and fenestration may be needed to prevent damage to the optic nerve.

Question 7

Intracranial hypertension viral sign symptoms ?

Answer 7

Cushing’s triad : late sign

Brady cardia
Wide pulse pressure (increased systolic)
Hypertension