Idiopathic intracranial hypertension (pseudotumor cerebri): Clinical features and diagnosis

INTRODUCTION

Idiopathic intracranial hypertension (IIH) is also commonly called pseudotumor cerebri. It is a disorder defined by clinical criteria that include symptoms and signs isolated to those produced by increased intracranial pressure (eg, headache, papilledema, vision loss), elevated intracranial pressure with normal cerebrospinal fluid composition, and no other cause of intracranial hypertension evident on neuroimaging or other evaluations [1].

While once called benign intracranial hypertension, to distinguish it from secondary intracranial hypertension produced by a neoplastic malignancy, it is not a benign disorder. Many patients suffer from intractable, disabling headaches, and there is a risk of severe, permanent vision loss.

This topic will discuss the clinical features and diagnosis of IIH. The epidemiology and pathogenesis, as well as the prognosis and treatment of this disorder are discussed separately. (See "Idiopathic intracranial hypertension (pseudotumor cerebri): Epidemiology and pathogenesis" and "Idiopathic intracranial hypertension (pseudotumor cerebri): Prognosis and treatment".)

SYMPTOMS

In one case series, the most common symptoms of idiopathic intracranial hypertension (IIH) were [2]:

  • Headache (92 percent)
  • Transient visual obscurations (72 percent)
  • Intracranial noises (pulsatile tinnitus) (60 percent)
  • Photopsia (54 percent)
  • Retrobulbar pain (44 percent)
  • Diplopia (38 percent)
  • Sustained visual loss (26 percent)

                   

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Literature review current through: Apr 2013. | This topic last updated: Oct 10, 2012.
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