Idiopathic Intracranial Hypertension: A Multidisciplinary Approach and the Role of the Neurosurgeon Case-Based Approach

Many conditions that neurosurgeons manage are associated with neuro-ophthalmic and neurologic symptoms. Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure with associated signs and symptoms to include visual disturbances, pulsatile tinnitus, and headache. IIH is considered a lifelong disease. Although elevated intracranial pressure itself may not be life-threatening, the real threat for patients with IIH is visual loss. For that reason, it is imperative that a neuro-ophthalmologist and/or comprehensive eye care provider determine visual function (visual acuity and visual fields) in a patient with IIH. Accurate understanding of the diagnostic criteria, interpretation of visual results, and headache history can help the neurosurgeon in determining whether their patient needs surgery. Many patients with IIH also have associated headache and migraine conditions. The collaboration between a neurologist, ophthalmologist, and neurosurgeon is crucial for providing the highest quality of care for patients with IIH.