Idiopathic intracranial hypertension (IIH) is a syndrome characterised by increased intracranial pressure and its associated signs and symptoms in an alert and orientated patient but without localising neurological ﬁndings. There is no evidence of deformity or obstruction of the ventricular system, and neurodiagnostic studies are otherwise normal except for increased cerebrospinal fluid (CSF) pressure. Furthermore, no secondary cause of intracranial hypertension is apparent. The disease can either be self-limited or have a lifelong chronic course.
Clinical features about which patients should be asked include headaches, neck and shoulder pain, pulse-synchronous tinnitus, transient visual obscurations, photophobia, visual loss, and diplopia.
Signs that may be found on examination include optic disc swelling, sixth nerve paresis, and disturbances in sensory visual function. Visual field loss is ubiquitous, and the prototype pattern for early loss is enlargement of the blind spot and inferonasal loss. The modified Dandy criteria can be used as diagnostic criteria.
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