BACKGROUND Increased intracranial pressure can be attributable to many causes, including venous thrombosis and space-occupying lesions. However, a very common disorder is idiopathic intracranial hypertension (IIH). REVIEW SUMMARY IIH is a condition seen in obese women of childbearing age. Although the incidence is 1 in 100,000 in normal-weight individuals, the incidence jumps to 20 in 100,000 in women who are obese. Symptoms include headache, transient visual obscurations, and tinnitus. IIH is characterized by papilledema. The diagnosis is made by a scanning procedure to rule out other causes of intracranial hypertension, including venous sinus thrombosis. The spinal fluid examination must be performed to document elevated intracranial pressure and show that the spinal fluid is normal. Evaluations for this condition consist of a neuro-ophthalmic examination, including visual acuity and visual fields. The patient must be followed carefully for changes in visual field function, because treatment options are affected by the effect of intracranial pressure on visual function. Treatment is aimed at reducing pressure, usually medically, with diuretics such as acetazolamide. If a patient begins to lose vision, optic nerve sheath decompression or lumboperitoneal shunting has been suggested. Children may also lose vision; therefore, careful attention must also be paid to children with this condition. IIH has a profound impact on the quality of life for individual patients. CONCLUSIONS Because IIH is a common disorder, all neurologists should be familiar with the symptoms and signs as well as the evaluation and treatment.
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Digre et al. (2001) studied this question.