A syndrome in which patients present with symptoms and signs of elevated intracranial pressure, the nature of which may be either idiopathic or due to various causative factors.
Headache, transient episodes of visual loss (typically lasting seconds) often precipitated by changes in posture, double vision, pulsatile tinnitus, nausea, or vomiting accompanying the headache. Occurs predominantly in obese women.
Critical
By definition, the following findings are present:
Other
See 10.15, PAPILLEDEMA. Unilateral or bilateral sixth cranial nerve palsy may be present. There are no other neurologic signs on examination aside from possible sixth cranial nerve palsy.
See 10.15, PAPILLEDEMA.
Associated Factors
Obesity, significant weight gain, and pregnancy are often associated with the idiopathic form. Possible causative factors include various medications such as oral contraceptives, tetracyclines (including semisynthetic derivatives, e.g., doxycycline), cyclosporine, vitamin A (>100,000 U/d), amiodarone, sulfa antibiotics, lithium, and historically nalidixic acid (now rarely used). Systemic steroid intake and withdrawal may also be causative.
Idiopathic intracranial hypertension may be a self-limited process. Treatment is indicated in the following situations:
Methods of treatment include the following:
If treatment by these methods is unsuccessful, consider a surgical intervention:
Special Circumstances