Idiopathic intracranial hypertension

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Presentation

  • Features of IC pressure in an alert patient (papilledema, headaches)
  • Sixth nerve palsy
  • Normal neuroimaging
  • Normal CSF (except for ↑opening pressure)

Complications

Vision loss

Treatment

  • Acetazolamide
  • Add furosemide if non-responsive
  • Weight loss might help
  • Surgery (sheath decompression or shunt) if refractory symptoms and progressive vision loss
  • Steroids and serial LP are a bridge to surgery