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Thursday 29 December 2011

Idiopathic intracranial hypertension

- a.k.a benign intracranial hypertension or pseudotumor cerebri
- most common in obese young women between age 20-50
- headache (worse with straining and bending forward), visual blurring with papilloedema are common features
- 4 diagnostic criteria must be met
  i) sign and symptoms of increased ICP
  ii) normal or small size ventricles seen on neuroimaging
  iii) increased CSF pressure with normal composition
  iv) papilledema
- associated factors: OCP, steroids, vitamin A, tetracycline, nitrofurantoin
- opening pressure on LP : >25cm water
- complication: optic nerve infarction or blindness
- treatment: repeated lumbar puncture, acetazolamide, thiazide diuretics, surgical decompression or shunting (lumboperitoneal shunt), trial of steroid for severe cases at risk of visual impairment due to papilloedema, optic nerve fenestration

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