IIH

Question 1

Symptom?

Answer 1

This patient presents with symptoms and signs
suggestive of idiopathic intracranial hypertension (IIH), such as headaches,
visual disturbances, and papilloedema.

Question 2

These are the first-line imaging
investigations to exclude a mass lesion or hydrocephalus in cases of
suspected idiopathic intracranial hypertension (IIH).

Answer 2

• MRI with contrast or MR venogram:

Question 3

If MRI unavailable?

Answer 3

CT scan

Question 4

Next step after imaging?

Answer 4

Once structural abnormalities have been excluded by
imaging, the next step is to perform a lumbar puncture.

This measures the
opening pressure, confirming raised intracranial pressure, which is diagnostic
of IIH.

The cerebrospinal fluid (CSF) can also be analysed to rule out infections
or other causes, such as subarachnoid haemorrhage

Question 5

monitoring progression?

Answer 5

• Visual Field Testing - While important for monitoring papilloedema
and potential visual loss in IIH

Question 6

DD?

Answer 6

venous sinus thrombosis
mass lesions.

Question 7

Mng?

Answer 7

• Weight loss:
• Medications: Acetazolamide ( reduce CSF production and
lower ICP. )

Topiramate and Prednisolone may also be beneficial.

• Procedures: Repeated lumbar punctures or optic nerve sheath fenestration

be performed to alleviate symptoms and prevent visual loss in severe cases