Idiopathic intracranial hypertension

Last reviewed: 30 May 2022
Last updated: 04 Feb 2022

Summary

Definition

History and exam

Key diagnostic factors

  • visual field loss
More key diagnostic factors

Other diagnostic factors

  • headache
  • transient visual obscurations
  • pulse-synchronous tinnitus
  • photophobia
  • retrobulbar pain
  • optical disk swelling
  • decreased visual acuity
  • ocular motility disturbances
  • relative afferent pupillary defect
Other diagnostic factors

Risk factors

  • female sex
  • obesity and weight gain
  • certain medication use
  • associated causal diseases
  • sleep apnea
  • family history
More risk factors

Diagnostic investigations

1st investigations to order

  • visual field testing (perimetry)
  • dilated fundoscopy
  • visual acuity
  • MRI of brain with or without contrast
  • lumbar puncture at spinal L3/L4
More 1st investigations to order

Investigations to consider

  • magnetic resonance venogram of head
  • optical coherence tomography
More investigations to consider

Treatment algorithm

ACUTE

all patients

Contributors

Authors

Michael Wall, MD

Professor

Department of Neurology and Department of Ophthalmology & Visual Sciences

University of Iowa Hospitals & Clinics and Iowa City VA Health Care System

Iowa City

IA

Disclosures

MW is an author of a number of references cited in this topic.

Mansoor Mughal, MD

Retina Fellow

Rutgers University

Robert Wood Johnson University Hospital

New Brunswick

NJ

Disclosures

MM declares that he has no competing interests.

Peer reviewers

Paul W. Brazis, MD

Consultant in Neurology and Neuro-Ophthalmology

Mayo Clinic Florida

Jacksonville

FL

Disclosures

PWB declares that he has no competing interests.

Tim D. Matthews, MBBS

Consultant Neuro-ophthalmologist

Birmingham Neuro-ophthalmology Unit

University Hospital Birmingham

Birmingham

UK

Disclosures

TDM declares that he has no competing interests.

  • Idiopathic intracranial hypertension images
  • Differentials

    • Intracranial structural anomalies
    More Differentials
  • Guidelines

    • European Headache Federation guideline on idiopathic intracranial hypertension
    More Guidelines
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    Obesity - diet and exercise

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