Idiopathic Intracranial Hypertension

Question 1

What are 2 causes?

Answer 1

Impaired absorption of CSF from sub-arachnoid space

Space-occupying lesions

Question 2

S+S:

Generalised throbbing headache:

• What time of day is it worse? - 2
• What 3 movements make it worse which could be a red flag sign?

What visual symptoms may you have? - 2
What visual signs may you fundoscopy? - 3

Other symptoms

You may also get a CN 6 palsy. What visual symptom will a patient complain of?

Answer 2

Morning and last thing at night

Lying, bending and coughing

Blurred vision
Field loss on bending
Flashes

Papilloedema
Enlarged blind spot
Absent venous pulsation on fundoscopy

N&V
Seizures

Diplopia

Question 3

Risk factors:

Which sex is it more common in?
Lifestyle

Answer 3

Females

Obesity

Question 4

DDx:

Answer 4

Space occupying lesion
Haemorrhage - subdural, extradural, subarachnoid, intracerebral

Central venous thrombosis
Cerebral oedema
Malignant hypertension

Question 5

Investigations:

Imaging used?

Why do we use imaging?

Wha scan can be used for a cerebral venous thrombosis?

Answer 5

CT/MRI

Rule out mass
Hydrocephalus
Other causes

CT/MRI venography

Question 6

Management:

Lifestyle change

Med used that reduces CSF production?

Answer 6

Weight loss

Acetazolamide - carbonic anhydrase inhibitor

Question 7

Complications:

What may occur from CN 2 damage?

Answer 7

Permanent blindness