Neuro-Ophthalmology
Idiopathic Intracranial Hypertension (IIH)

Idiopathic intracranial hypertension (IIH) is also known as pseudotumor cerebri.  IIH causes increased intracranial pressure (increased pressure in the brain).   The cause of IIH is unknown.

IIH typically affects women of childbearing age.  Recent weight gain and/or being overweight are additional risk factors.

Symptoms and Signs
1.  Almost all patients have a daily or near daily generalized headache of fluctuating intensity.
2.  Double vision
3.  Transient visual obscurations (dimming of vision)
4.  Pulsatile intracranial tinnitus (swooshing sound in the ears)
5.  Vision loss begins peripherally and may not be noticed by patients until late in the course.  Permanent vision loss is the most serious consequence.

Diagnosis
1.  Your ophthalmologist may detect papilledema (swelling of the optic nerves)
2.  MRI - no tumors or other abnormalities should be detected
3.  Lumbar puncture - the opening pressure will be elevated but the cerebrospinal fluid will be normal

Treatment
1.  Weight loss
2.  Acetazolamide (diamox) pills
3.  Headache medicines
4.  Rarely, if vision deteriorates despite treatment, surgery may be indicated.

Frequent ophthalmologic assessment is required to monitor response to treatment and to prevent permanent vision loss.


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