Idiopathic Intracranial Hypertension: Symptoms, Causes and Treatment
Idiopathic intracranial hypertension is a neurological disorder that is triggered by increased intracranial pressure. Also called benign intracranial hypertension and pseudotumor cerebri, the condition does not involve the formation of a tumor or any other trigger disease...
The history of Idiopathic Intracranial Hypertension dates back to 1893. Heinrich Quincke, a German physician, documented his studies as observations of 'serous meningitis'. A compatriot, Max Nonne, coined the term 'pseudotumor cerebri' in 1904, for the same condition. Diagnostic criteria for Idiopathic Intracranial Hypertension was defined by Walter Dandy, a Baltimore neurosurgeon, in 1937.
Causes:
The intracranial pressure could result from medication, such as reaction to vitamin A derivatives, tetracycline antibiotics and oral contraceptives. The secondary causes commonly observed are delayed treatment of sleep apnea, chronic kidney diseases and systemic lupus erythematosus. The resultant pressure within the skull is determined by the CSF or cerebrospinal fluid, brain tissue and blood within the skull. Any imbalance in the volume or production of any of these three cranium components results in the development of Idiopathic Intracranial Hypertension.
Signs and Symptoms of Idiopathic Intracranial Hypertension:
Idiopathic Intracranial Hypertension manifests in the form of:
- Severe headache
- Nausea
- Vomiting
- Pulsatile tinnitus or persistent 'buzzing' sound in the ears
- Double vision
- Swelling of optic disc
- Fatigue
Idiopathic Intracranial Hypertension Treatment Options:
The treatment options for Idiopathic Intracranial Hypertension aim at preventing complete visual impairment. The medication and procedures involve focus on quick symptom control. The administration of acetazolamide Diamox helps reduce the symptoms by inhibiting the carbonic anhydrase enzyme and reducing CSF production. However, this could trigger the onset of hypokalemia or lowered blood potassium levels, which result in muscle weakness. Furosemide, a diuretic is also sometimes considered in the treatment of Idiopathic Intracranial Hypertension. The headache is usually controlled with analgesics and paracetamol agents. Depending on the psychosomatic triggers, anti-depressants and anti-convulsants are also administered. The treatment of Idiopathic Intracranial Hypertension also includes two surgical procedures, shunting and decompression of the optic nerve sheath.
Decompression of the optic nerve sheath and fenestration is an ophthalmological process. The surgeon makes an incision in the optic nerve connective tissue to trigger CSF diversion into the orbit. Shunt surgery is a neurosurgeon supervised procedure where a conduit is created to direct the CSF into another body cavity. While initiating the lumboperitoneal shunt in the subarachnoid space, a pressure valve is included in the lumbar spine and peritoneal cavity circuit to prevent excessive drainage. In case of an obese patient, the doctor may suggest gastric bypass surgery.

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