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

Andrew G Lee, MD
Michael Wall, MD
Section Editor
Paul W Brazis, MD
Deputy Editor
Janet L Wilterdink, MD


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. IIH primarily affects women of childbearing age who are overweight.

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. Even patients with mild vision loss have an associated reduction in quality of life [1].

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".)


A typical presentation of idiopathic intracranial hypertension IIH is that of an obese woman of childbearing age who complains of headaches and is found to have papilledema on funduscopic examination. Other potential high risk groups are discussed separately. (See "Idiopathic intracranial hypertension (pseudotumor cerebri): Epidemiology and pathogenesis", section on 'Risk factors' and "Idiopathic intracranial hypertension (pseudotumor cerebri): Epidemiology and pathogenesis", section on 'Associated conditions'.)

Symptoms — In one case series and in the Idiopathic Intracranial Hypertension Treatment Trial, the most common symptoms of idiopathic intracranial hypertension (IIH) were [2,3]:

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Literature review current through: Nov 2017. | This topic last updated: Jun 17, 2015.
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