Update on Idiopathic Intracranial Hypertension

Michael Wall, Michael Wall

Abstract

Idiopathic intracranial hypertension (IIH) is a disorder of elevated intracranial pressure of unknown cause occurring predominantly in young women of childbearing age. The typical patient symptom profile is the presence of daily headache, pulse synchronous tinnitus, transient visual obscurations, and papilledema with its associated visual loss. Although surgical procedures are performed for those who fail medical therapy, their relative efficacy remains unclear. The main morbidity of IIH is from visual loss. This visual loss is present in most patients and can usually be reversed if recognized early in the patients' course and treated.

Keywords: Acetazolamide; Idiopathic intracranial hypertension; Optical coherence tomography; Pseudotumor cerebri.

Copyright © 2016 Elsevier Inc. All rights reserved.

Figures

Figure 1
Figure 1
Clinical trial structure for the IIHTT.
Figure 2
Figure 2
Frequency of symptoms at study entry.
Figure 3
Figure 3
Perimetric mean deviation change over six months in the IIHTT.
Figure 4
Figure 4
ETDRS score of worst eye plotted against best eye. Shaded areas indicate vision of 20/20 or better.
Figure 5
Figure 5
The prototype visual field defect in IIH patients with mild loss: the inferior nasal arcuate defect. Not the arcuate pattern of the abnormal test locations flagged on the Total Deviation plot
Figure 6
Figure 6
Change in papilledema grade in the eye with the worst initial mean deviation over six months.
Figure 7
Figure 7
Reduction in CSF pressure over six months in the placebo and acetazolamide groups in the IIHTT.
Figure 8
Figure 8
Final dosage reached for placebo and acetazolamide subjects in the IIHTT.

Source: PubMed

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