The Search for Causes of Idiopathic Intracranial Hypertension

Idiopathic intracranial hypertension (pseudotumor cerebri) is a condition that occurs predominantly in obese women. It consists of elevated spinal fluid pressure, normal spinal fluid contents, papilledema, and headaches with normal imaging studies. Long lists of putative causes and associations have arisen, many consisting of individual case reports. We did a retrospective case-control study on 40 patients and 39 age- and sex-matched control subjects to examine the incidence of these associated conditions. Our results are only suggestive due to the small sample size; however, obesity and recent weight gain occurred more commonly in patients with idiopathic intracranial hypertension than in control subjects. All forms of menstrual abnormalities, incidence of pregnancy, antibiotic use, and oral contraceptive use were equal in both groups. A larger multicenter study will be needed to more completely characterize the risk factors for this condition.