Materiały źródłowe

• #1 Idiopathic intracranial hypertension (pseudotumor cerebri): Prognosis and treatment – UpToDate

  https://www.uptodate.com/contents/idiopathic-intracranial-hypertension-pseudotumor-cerebri-prognosis-and-treatment

  Idiopathic intracranial hypertension (IIH) was formerly called pseudotumor cerebri. It is a disorder defined by clinical criteria that include symptoms and signs isolated to those produced by increased intracranial pressure (ICP; eg, headache, papilledema, double vision, transient visual obscurations, and vision loss), elevated ICP with normal cerebrospinal fluid (CSF) composition, and no other cause of intracranial hypertension evident on neuroimaging or other evaluations. […] Many patients suffer from intractable, disabling headaches, and there is a risk of severe, permanent vision loss in approximately 5 to 15 percent of patients. […] The treatment of patients with IIH has two major goals: the alleviation of symptoms (usually headache) and the preservation of vision. […] Studies have attempted to identify patients at risk of severe, permanent vision loss. Features that appear to identify such patients include: Severe papilledema – IIH patients with higher-grade papilledema categorized as Frisén grades 3 to 5 are at risk for poor visual outcomes if not treated aggressively.

• #2 Pseudotumor Cerebri – Neurosurgery | UCLA Health

  https://www.uclahealth.org/medical-services/neurosurgery/conditions-treated/pseudotumor-cerebri

  Patients with pseudotumor cerebri have elevated intracranial pressure unrelated to tumor, hydrocephalus or brain swelling. […] The most common form of pseudotumor cerebri is idiopathic, with no associated factors. […] Treatment includes discontinuing offending drugs, weight loss, fluid and salt restrictions, use of diuretics to slow cerebrospinal fluid production and steroid treatment. […] Surgical treatment is reserved for the rare patient in whom medical management fails. Persistent symptoms or progressive visual deterioration warrant surgery. Several procedures are available. […] The Neuro-ICU cares for patients with all types of neurosurgical and neurological injuries, including stroke, brain hemorrhage, trauma and tumors.

• #3 Idiopathic Intracranial Hypertension: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21968-idiopathic-intracranial-hypertension

  Idiopathic intracranial hypertension (IIH) is increased pressure in your skull. It occurs because of cerebrospinal fluid buildup around your brain. The cause is unknown. It can affect your vision and cause headaches, nausea or ringing in your ears. Treatments are available. […] Let a healthcare provider know if you notice symptoms like changes to your vision in addition to a headache or ringing in your ears. Treatment options are available for IIH. […] IIH may lead to vision loss if untreated. This is irreversible. A healthcare provider can offer treatment options to prevent this complication, so let them know as soon as possible if you notice changes to your vision. […] The goals of IIH treatment are to decrease pressure on your brain and prevent vision loss. Depending on the severity, your healthcare provider may recommend: Taking medications, Undergoing surgery, Weight management.

• #4 Intracranial Hypertension (Pseudotumor Cerebri): Diagnosis & Treatment | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/intracranial-hypertension-pseudotumor-cerebri

  Idiopathic intracranial hypertension, sometimes called pseudotumor cerebri, is a condition in which the cerebro-spinal fluid is not able to drain normally. […] The ophthalmologist will closely monitor your child’s vision and the nerve swelling. Medicines to lower the pressure and bring down the nerve swelling are the most common treatment. […] The most important thing anyone can do to improve this condition is to maintain a healthy weight, or lose weight if obese. […] If treated, the outcome is good. If not treated, permanent blindness can occur.

• #5 Pseudotumor Cerebri – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK536924/

  Pseudotumor cerebri (PTC), also known as idiopathic intracranial hypertension (IIH), is a disorder with increased intracranial pressure (ICP) and associated headaches, papilledema, vision changes, or pulsatile tinnitus in the setting of normal imaging and cerebrospinal fluid (CSF) studies. It mainly affects overweight women of childbearing age. This activity reviews the cause and pathophysiology of pseudotumor cerebri and highlights the role of the interprofessional team in its management. […] Nurses should be aware of pupillary changes that often occur with an elevation of intracranial pressure. A prompt referral to a neurologist/neurosurgeon is necessary when the patient has unequal pupils, papilledema, and/or focal neurological deficits.

• #6 Vascular & Interventional Partners | Phoenix, AZ| IIH

  https://www.vipinterventional.com/conditions/idiopathic-intracranial-hypertension

  Idiopathic intracranial hypertension is a rare condition that causes an unexplained increase of pressure in the skull, leading to painful headaches and vision problems. […] IIH can occur in individuals of any age. However, it is more common in women between the ages of 20 and 50. In fact, about 19 out of 20 people with the condition are women. […] Women 20-40 are at risk for Idiopathic Intracranial Hypertension. […] Some of the symptoms of IIH can be similar to those of a brain tumor, such as headaches, vision changes, and nausea. […] IIH is diagnosed when no other cause or explanation is found for increased intracranial pressure. […] For most people, the symptoms of IIH improve with treatment, but your provider may recommend different options depending on the severity of your condition and overall health.

• #7 Idiopathic intracranial hypertension (pseudotumor cerebri): Prognosis and treatment – UpToDate

  https://www.uptodate.com/contents/idiopathic-intracranial-hypertension-pseudotumor-cerebri-prognosis-and-treatment

  Idiopathic intracranial hypertension (IIH) was formerly called pseudotumor cerebri. It is a disorder defined by clinical criteria that include symptoms and signs isolated to those produced by increased intracranial pressure (ICP; eg, headache, papilledema, double vision, transient visual obscurations, and vision loss), elevated ICP with normal cerebrospinal fluid (CSF) composition, and no other cause of intracranial hypertension evident on neuroimaging or other evaluations. […] Many patients suffer from intractable, disabling headaches, and there is a risk of severe, permanent vision loss in approximately 5 to 15 percent of patients. […] The treatment of patients with IIH has two major goals: the alleviation of symptoms (usually headache) and the preservation of vision. […] Studies have attempted to identify patients at risk of severe, permanent vision loss. Features that appear to identify such patients include: Severe papilledema – IIH patients with higher-grade papilledema categorized as Frisén grades 3 to 5 are at risk for poor visual outcomes if not treated aggressively.

• #8 Idiopathic Intracranial Hypertension | UC Health | Symptoms

  https://www.uchealth.com/en/conditions/idiopathic-intracranial-hypertension

  Idiopathic intracranial hypertension, or pseudotumor cerebri, is a disorder that is caused by a buildup of pressure from too much cerebrospinal fluid in the brain. […] The symptoms of IIH mimic those of a true brain tumor. The main sign is unusually high pressure inside the skull. This is known as intracranial hypertension. […] Treatment can vary based on what is causing the fluid to build up inside the skull. Treatment options include: Losing weight, if needed. Limiting fluids or salt in the diet. Taking medicines, such as water pills (diuretics). These help the body to get rid of extra fluid. […] Untreated IIH can result in permanent problems such as vision loss. Have regular eye exams and checkups treat any eye problems before they get worse. […] Any changes in vision should be checked out by a healthcare provider right away. Diagnosis and treatment can help prevent long-term complications such as vision loss.

• #9 A Second Helping

  https://www.reviewofoptometry.com/article/ro1117-a-second-helping

  Even optometrists who see it infrequently know that papilledema is defined as bilateral disc edema secondary to increased ICP, and identification is often straightforward. […] The most common general symptoms of pseudotumor cerebri include headaches in the morning that intensify with movement, projectile vomiting, neck pain, tinnitus (whooshing or ringing in the ears) and loss of consciousness. Ocular symptoms include blurred vision, transient visual obscuration, vision loss, retro-orbital pain and horizontal diplopia. […] Diagnostic criteria. IIH is diagnosed based on the modified Dandy criteria, which include: signs and symptoms of increased ICP, no localized neurologic findings, normal neuroimaging with the exception of an empty sella (dark appearance of the sella tursica on T1-weighted MRI from increased CSF), opening LP pressure of greater than 250mm H2O with normal CSF and no other causes of increased ICP.

• #10 Idiopathic intracranial hypertension (pseudotumor cerebri): Prognosis and treatment – UpToDate

  https://www.uptodate.com/contents/idiopathic-intracranial-hypertension-pseudotumor-cerebri-prognosis-and-treatment

  Idiopathic intracranial hypertension (IIH) was formerly called pseudotumor cerebri. It is a disorder defined by clinical criteria that include symptoms and signs isolated to those produced by increased intracranial pressure (ICP; eg, headache, papilledema, double vision, transient visual obscurations, and vision loss), elevated ICP with normal cerebrospinal fluid (CSF) composition, and no other cause of intracranial hypertension evident on neuroimaging or other evaluations. […] Many patients suffer from intractable, disabling headaches, and there is a risk of severe, permanent vision loss in approximately 5 to 15 percent of patients. […] The treatment of patients with IIH has two major goals: the alleviation of symptoms (usually headache) and the preservation of vision. […] Studies have attempted to identify patients at risk of severe, permanent vision loss. Features that appear to identify such patients include: Severe papilledema – IIH patients with higher-grade papilledema categorized as Frisén grades 3 to 5 are at risk for poor visual outcomes if not treated aggressively.

• #11 A Second Helping

  https://www.reviewofoptometry.com/article/ro1117-a-second-helping

  Even optometrists who see it infrequently know that papilledema is defined as bilateral disc edema secondary to increased ICP, and identification is often straightforward. […] The most common general symptoms of pseudotumor cerebri include headaches in the morning that intensify with movement, projectile vomiting, neck pain, tinnitus (whooshing or ringing in the ears) and loss of consciousness. Ocular symptoms include blurred vision, transient visual obscuration, vision loss, retro-orbital pain and horizontal diplopia. […] Diagnostic criteria. IIH is diagnosed based on the modified Dandy criteria, which include: signs and symptoms of increased ICP, no localized neurologic findings, normal neuroimaging with the exception of an empty sella (dark appearance of the sella tursica on T1-weighted MRI from increased CSF), opening LP pressure of greater than 250mm H2O with normal CSF and no other causes of increased ICP.

• #12 A Second Helping

  https://www.reviewofoptometry.com/article/ro1117-a-second-helping

  Even optometrists who see it infrequently know that papilledema is defined as bilateral disc edema secondary to increased ICP, and identification is often straightforward. […] The most common general symptoms of pseudotumor cerebri include headaches in the morning that intensify with movement, projectile vomiting, neck pain, tinnitus (whooshing or ringing in the ears) and loss of consciousness. Ocular symptoms include blurred vision, transient visual obscuration, vision loss, retro-orbital pain and horizontal diplopia. […] Diagnostic criteria. IIH is diagnosed based on the modified Dandy criteria, which include: signs and symptoms of increased ICP, no localized neurologic findings, normal neuroimaging with the exception of an empty sella (dark appearance of the sella tursica on T1-weighted MRI from increased CSF), opening LP pressure of greater than 250mm H2O with normal CSF and no other causes of increased ICP.

• #13 Intracranial Hypertension | Keck Medicine of USC

  https://www.keckmedicine.org/conditions/intracranial-hypertension/

  Our multidisciplinary center of excellence offers fast, expert care for idiopathic intracranial hypertension. […] Symptoms of PTCS and idiopathic intracranial hypertension may include headaches, neck pain, vision changes and/or pulsing sounds in your ears. While the symptoms can be mild, the disease can sometimes cause rapid vision loss and requires expert care. Our team is highly experienced in the diagnosis, treatment and management of PTCS and idiopathic intracranial hypertension. […] We treat your PTCS and idiopathic intracranial hypertension by addressing any underlying cause of the high pressure. Based on your unique symptoms and needs, treatment options such as medications, weight loss and surgery may be needed to manage your condition. Our team will work in close collaboration to find the treatment plan that’s best for you.

• #14 A Second Helping

  https://www.reviewofoptometry.com/article/ro1117-a-second-helping

  Even optometrists who see it infrequently know that papilledema is defined as bilateral disc edema secondary to increased ICP, and identification is often straightforward. […] The most common general symptoms of pseudotumor cerebri include headaches in the morning that intensify with movement, projectile vomiting, neck pain, tinnitus (whooshing or ringing in the ears) and loss of consciousness. Ocular symptoms include blurred vision, transient visual obscuration, vision loss, retro-orbital pain and horizontal diplopia. […] Diagnostic criteria. IIH is diagnosed based on the modified Dandy criteria, which include: signs and symptoms of increased ICP, no localized neurologic findings, normal neuroimaging with the exception of an empty sella (dark appearance of the sella tursica on T1-weighted MRI from increased CSF), opening LP pressure of greater than 250mm H2O with normal CSF and no other causes of increased ICP.

• #15 Pseudotumor Cerebri (Idiopathic Intracranial Hypertension) – EyeWiki

  https://eyewiki.org/Pseudotumor_Cerebri_(Idiopathic_Intracranial_Hypertension)

  Pseudotumor cerebri, also known as idiopathic intracranial hypertension (IIH), is a disorder characterized by increased intracranial pressure (ICP) of unknown cause that predominantly affects obese women of childbearing age. Papilledema is the primary ocular finding and may progressively lead to optic atrophy and blindness if no treatment is provided. Variable treatment options are available, but there are no formal guidelines with regards to therapeutic approach. […] The goal of treatment is to alleviate symptoms of ICP and preserve vision. Although diagnostic lumbar puncture may provide symptom relief the latter is often transient and requires combination with further long-term therapy. […] All obese patients should be encouraged to lose modest amount of weight. Among patients who are obese or overweight, weight loss of about 5-10% has been found to improve symptoms and signs. In a recent study, weight loss allowed a decrease in headaches, papilledema, and ICP. However, the latter option is not effective for acute symptomatic relief and management and therefore needs to be combined with further acute treatment.

• #16 Pseudotumor Cerebri – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK536924/

  Pseudotumor cerebri (PTC), also known as idiopathic intracranial hypertension (IIH), is a disorder with increased intracranial pressure (ICP) and associated headaches, papilledema, vision changes, or pulsatile tinnitus in the setting of normal imaging and cerebrospinal fluid (CSF) studies. It mainly affects overweight women of childbearing age. This activity reviews the cause and pathophysiology of pseudotumor cerebri and highlights the role of the interprofessional team in its management. […] Nurses should be aware of pupillary changes that often occur with an elevation of intracranial pressure. A prompt referral to a neurologist/neurosurgeon is necessary when the patient has unequal pupils, papilledema, and/or focal neurological deficits.

• #17 A Second Helping

  https://www.reviewofoptometry.com/article/ro1117-a-second-helping

  Even optometrists who see it infrequently know that papilledema is defined as bilateral disc edema secondary to increased ICP, and identification is often straightforward. […] The most common general symptoms of pseudotumor cerebri include headaches in the morning that intensify with movement, projectile vomiting, neck pain, tinnitus (whooshing or ringing in the ears) and loss of consciousness. Ocular symptoms include blurred vision, transient visual obscuration, vision loss, retro-orbital pain and horizontal diplopia. […] Diagnostic criteria. IIH is diagnosed based on the modified Dandy criteria, which include: signs and symptoms of increased ICP, no localized neurologic findings, normal neuroimaging with the exception of an empty sella (dark appearance of the sella tursica on T1-weighted MRI from increased CSF), opening LP pressure of greater than 250mm H2O with normal CSF and no other causes of increased ICP.

• #18 UT Health Austin | Pseudotumor Cerebri Syndrome

  https://uthealthaustin.org/conditions/pseudotumor-cerebri-syndrome

  Pseudotumor Cerebri Syndrome (meaning false tumor), also called idiopathic intracranial hypertension, is a condition that causes increased cerebrospinal fluid pressure in the brain, typically triggered by weight gain or obesity. […] A careful eye exam and testing of the visual fields is crucial to determine the risk of vision loss in patients with pseudotumor cerebri syndrome. […] At UT Health Austin, we take a multidisciplinary approach to your care. This means you will benefit from the expertise of multiple specialists across a variety of disciplines. Your care team will include fellowship-trained neuro-ophthalmologists, ophthalmic technicians, physician assistants, nurse practitioners, social workers, and more who work together to help you get back to the things in your life that matter most to you. […] We are committed to communicating and coordinating your care with your other healthcare providers to ensure that we are providing you with comprehensive, whole-person care.

• #19 A High-Pressure Situation: Idiopathic Intracranial Hypertension Diagnosis and Treatments – Ophthalmology Advisor

  https://www.ophthalmologyadvisor.com/features/pseudotumor-cerebri-iih-diagnosis-protocol-and-treatment-options/

  Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri, is a disorder of increased intracranial pressure (ICP), defined as more than 250 mm H2O opening pressure, in the presence of normal neuroimaging and normal cerebral spinal fluid (CSF) content. This condition typically affects women of child-bearing age with obesity, and its most common initial symptoms are headache, transient visual obscurations, back pain, and pulse synchronous tinnitus. The goals of treatment with IIH are to limit visual morbidity from persistent optic nerve edema and to relieve symptoms, which is most commonly headache. Rapid weight gain in addition to use of tetracycline antibiotics, lithium, renal failure, anemia vitamin A derivatives such as isotretinoin, and exogenous testosterone are well-established associations with IIH, but the pathophysiology of the disease remains elusive. A careful medical history should be elicited, including symptomatology, recent weight gain, and use of potential offending medications. Next, a complete ocular evaluation is indicated, as fundus photography or optical coherence tomography (OCT) alone should not be relied upon to screen for the presence of papilledema. Weight loss and treatment with carbonic anhydrase inhibitors (CAI) such as acetazolamide are the mainstays of managing IIH. An important consideration that should be discussed with IIH patients is the potential risk of acetazolamide for pregnancy. If a patient has fulminant disease with progressive vision loss refractory to medical therapy, or if the patient is unable to tolerate medical management, surgical treatment may be necessary. Careful adherence to the diagnostic criteria of IIH minimizes the risk of misdiagnosis and expedites appropriate disease management. […] Most patients will respond to medical therapy and weight loss alone, but select cases require surgical intervention to treat progressive visual field loss and refractory headaches.

• #20 Idiopathic intracranial hypertension (pseudotumor cerebri): Prognosis and treatment – UpToDate

  https://www.uptodate.com/contents/idiopathic-intracranial-hypertension-pseudotumor-cerebri-prognosis-and-treatment

  Idiopathic intracranial hypertension (IIH) was formerly called pseudotumor cerebri. It is a disorder defined by clinical criteria that include symptoms and signs isolated to those produced by increased intracranial pressure (ICP; eg, headache, papilledema, double vision, transient visual obscurations, and vision loss), elevated ICP with normal cerebrospinal fluid (CSF) composition, and no other cause of intracranial hypertension evident on neuroimaging or other evaluations. […] Many patients suffer from intractable, disabling headaches, and there is a risk of severe, permanent vision loss in approximately 5 to 15 percent of patients. […] The treatment of patients with IIH has two major goals: the alleviation of symptoms (usually headache) and the preservation of vision. […] Studies have attempted to identify patients at risk of severe, permanent vision loss. Features that appear to identify such patients include: Severe papilledema – IIH patients with higher-grade papilledema categorized as Frisén grades 3 to 5 are at risk for poor visual outcomes if not treated aggressively.

• #21 Idiopathic Intracranial Hypertension (IIH) Treatment & Management: Approach Considerations, Pharmacologic Therapy, Optic Nerve Sheath Fenestration, CSF Diversion, and Venous Sinus Stenting

  https://emedicine.medscape.com/article/1214410-treatment

  The frequency of the follow-up visits is determined by a number of factors, to include the following: Initial visual function of the patient, underlying disease causing increased ICP, perceived compliance of the patient with medical therapy. […] Once the initial diagnosis has been established, investigations have been performed, and therapy has been initiated, the patient can be observed every 3 to 4 weeks. […] If, however, the patient presents with a significant visual function deficit or marked papilledema, frequent monitoring for 1 to 2 weeks is appropriate until some improvement and subsequent stability in visual function can be demonstrated. […] The Idiopathic Intracranial Hypertension Treatment Trial identified that the risk factors for treatment failure included male sex, high-grade papilledema, low baseline visual acuity, and increased number of transient visual obscuration episodes per month. Among patients with these risk factors, the IIHTT recommends closer monitoring while considering more aggressive treatment options.

• #22 Idiopathic intracranial hypertension (pseudotumor cerebri): Prognosis and treatment – UpToDate

  https://www.uptodate.com/contents/idiopathic-intracranial-hypertension-pseudotumor-cerebri-prognosis-and-treatment

  Idiopathic intracranial hypertension (IIH) was formerly called pseudotumor cerebri. It is a disorder defined by clinical criteria that include symptoms and signs isolated to those produced by increased intracranial pressure (ICP; eg, headache, papilledema, double vision, transient visual obscurations, and vision loss), elevated ICP with normal cerebrospinal fluid (CSF) composition, and no other cause of intracranial hypertension evident on neuroimaging or other evaluations. […] Many patients suffer from intractable, disabling headaches, and there is a risk of severe, permanent vision loss in approximately 5 to 15 percent of patients. […] The treatment of patients with IIH has two major goals: the alleviation of symptoms (usually headache) and the preservation of vision. […] Studies have attempted to identify patients at risk of severe, permanent vision loss. Features that appear to identify such patients include: Severe papilledema – IIH patients with higher-grade papilledema categorized as Frisén grades 3 to 5 are at risk for poor visual outcomes if not treated aggressively.

• #23 Idiopathic Intracranial Hypertension

  https://practicalneurology.com/diseases-diagnoses/headache-pain/idiopathic-intracranial-hypertension/31655/

  Treatment of idiopathic intracranial hypertension should be started as soon as diagnosis is confirmed to prevent vision loss. […] Once the diagnosis is confirmed, medical and surgical treatments, as well as lifestyle changes, should be implemented in order to prevent vision loss. […] The potential for vision loss requires timely identification and treatment of IIH. […] If left untreated, patients will continue to have constriction of visual fields and may progress to blindness due to optic disc edema and subsequent ischemia. […] Treatment of IIH is directed at lowering ICP in order to improve vision and headache. […] The management of IIH is multimodal and includes lifestyle measures (ie, diet and weight loss), medical therapy, and surgical procedures if medical treatment does not improve IIH.

• #24 Idiopathic Intracranial Hypertension

  https://practicalneurology.com/diseases-diagnoses/headache-pain/idiopathic-intracranial-hypertension/31655/

  Treatment of idiopathic intracranial hypertension should be started as soon as diagnosis is confirmed to prevent vision loss. […] Once the diagnosis is confirmed, medical and surgical treatments, as well as lifestyle changes, should be implemented in order to prevent vision loss. […] The potential for vision loss requires timely identification and treatment of IIH. […] If left untreated, patients will continue to have constriction of visual fields and may progress to blindness due to optic disc edema and subsequent ischemia. […] Treatment of IIH is directed at lowering ICP in order to improve vision and headache. […] The management of IIH is multimodal and includes lifestyle measures (ie, diet and weight loss), medical therapy, and surgical procedures if medical treatment does not improve IIH.

• #25 Idiopathic Intracranial Hypertension

  https://practicalneurology.com/diseases-diagnoses/headache-pain/idiopathic-intracranial-hypertension/31655/

  Treatment of idiopathic intracranial hypertension should be started as soon as diagnosis is confirmed to prevent vision loss. […] Once the diagnosis is confirmed, medical and surgical treatments, as well as lifestyle changes, should be implemented in order to prevent vision loss. […] The potential for vision loss requires timely identification and treatment of IIH. […] If left untreated, patients will continue to have constriction of visual fields and may progress to blindness due to optic disc edema and subsequent ischemia. […] Treatment of IIH is directed at lowering ICP in order to improve vision and headache. […] The management of IIH is multimodal and includes lifestyle measures (ie, diet and weight loss), medical therapy, and surgical procedures if medical treatment does not improve IIH.

• #26 Idiopathic Intracranial Hypertension (IIH) Center – Neurosurgery | Northwell Health

  https://nsuh.northwell.edu/neurosurgery/idiopathic-intracranial-hypertension-center

  Patients with IIH (idiopathic intracranial hypertension, also called pseudotumor cerebri) require multidisciplinary care for both diagnosis and treatment. […] The Idiopathic Intracranial Center at North Shore University Hospital is one of few in the country and the only one on Long Island with an experienced, multidisciplinary team of physicians treating this condition. […] Surgical treatments are considered for patients who do not tolerate or benefit from medical therapy. […] We offer treatments for: Idiopathic intracranial hypertension.

• #27 Intracranial Hypertension | Keck Medicine of USC

  https://www.keckmedicine.org/conditions/intracranial-hypertension/

  Our specialists at the USC Intracranial Pressure Center of Excellence create a treatment plan tailored to your PTCS and idiopathic intracranial hypertension symptoms. […] We give you access to a multidisciplinary team, including neurologists, neurosurgeons, radiologists, dietitians and ophthalmologists, to provide faster care.

• #28 Improving pediatric idiopathic intracranial hypertension care: a retrospective cohort study | Scientific Reports

  https://www.nature.com/articles/s41598-022-23960-w

  The type of follow-up was the only significant factor associated with recurrent unscheduled ER and hospital admissions. […] In agreement with our initial hypothesis, we found that children who were under the care of a multidisciplinary team in a tertiary center had significantly lower odds of returning to the hospital, a lower rate of resulting inpatient days, as well as longer time intervals between hospital returns, compared to children followed by individual specialists elsewhere. […] This multidisciplinary approach improves the outcome of children with IIH compared to follow-ups by specialists in other settings.

• #29 Idiopathic intracranial hypertension (pseudotumor cerebri): Prognosis and treatment – UpToDate

  https://www.uptodate.com/contents/idiopathic-intracranial-hypertension-pseudotumor-cerebri-prognosis-and-treatment/print

  Idiopathic intracranial hypertension (IIH) was formerly called pseudotumor cerebri. It is a disorder defined by clinical criteria that include symptoms and signs isolated to those produced by increased intracranial pressure (ICP; eg, headache, papilledema, double vision, transient visual obscurations, and vision loss), elevated ICP with normal cerebrospinal fluid (CSF) composition, and no other cause of intracranial hypertension evident on neuroimaging or other evaluations. […] The treatment of patients with IIH has two major goals: the alleviation of symptoms (usually headache) and the preservation of vision. […] Patients require regular ophthalmology follow-up visits until they stabilize. Follow-up visit intervals are individualized based on the severity, duration, and response to treatment of the clinical manifestations, but initially should be at least monthly in patients with moderate symptoms.

• #30 Idiopathic Intracranial Hypertension (IIH) Treatment & Management: Approach Considerations, Pharmacologic Therapy, Optic Nerve Sheath Fenestration, CSF Diversion, and Venous Sinus Stenting

  https://emedicine.medscape.com/article/1214410-treatment

  The frequency of the follow-up visits is determined by a number of factors, to include the following: Initial visual function of the patient, underlying disease causing increased ICP, perceived compliance of the patient with medical therapy. […] Once the initial diagnosis has been established, investigations have been performed, and therapy has been initiated, the patient can be observed every 3 to 4 weeks. […] If, however, the patient presents with a significant visual function deficit or marked papilledema, frequent monitoring for 1 to 2 weeks is appropriate until some improvement and subsequent stability in visual function can be demonstrated. […] The Idiopathic Intracranial Hypertension Treatment Trial identified that the risk factors for treatment failure included male sex, high-grade papilledema, low baseline visual acuity, and increased number of transient visual obscuration episodes per month. Among patients with these risk factors, the IIHTT recommends closer monitoring while considering more aggressive treatment options.

• #31 Idiopathic Intracranial Hypertension (IIH) Treatment & Management: Approach Considerations, Pharmacologic Therapy, Optic Nerve Sheath Fenestration, CSF Diversion, and Venous Sinus Stenting

  https://emedicine.medscape.com/article/1214410-treatment

  The frequency of the follow-up visits is determined by a number of factors, to include the following: Initial visual function of the patient, underlying disease causing increased ICP, perceived compliance of the patient with medical therapy. […] Once the initial diagnosis has been established, investigations have been performed, and therapy has been initiated, the patient can be observed every 3 to 4 weeks. […] If, however, the patient presents with a significant visual function deficit or marked papilledema, frequent monitoring for 1 to 2 weeks is appropriate until some improvement and subsequent stability in visual function can be demonstrated. […] The Idiopathic Intracranial Hypertension Treatment Trial identified that the risk factors for treatment failure included male sex, high-grade papilledema, low baseline visual acuity, and increased number of transient visual obscuration episodes per month. Among patients with these risk factors, the IIHTT recommends closer monitoring while considering more aggressive treatment options.

• #32 Idiopathic Intracranial Hypertension (IIH) Treatment & Management: Approach Considerations, Pharmacologic Therapy, Optic Nerve Sheath Fenestration, CSF Diversion, and Venous Sinus Stenting

  https://emedicine.medscape.com/article/1214410-treatment

  The frequency of the follow-up visits is determined by a number of factors, to include the following: Initial visual function of the patient, underlying disease causing increased ICP, perceived compliance of the patient with medical therapy. […] Once the initial diagnosis has been established, investigations have been performed, and therapy has been initiated, the patient can be observed every 3 to 4 weeks. […] If, however, the patient presents with a significant visual function deficit or marked papilledema, frequent monitoring for 1 to 2 weeks is appropriate until some improvement and subsequent stability in visual function can be demonstrated. […] The Idiopathic Intracranial Hypertension Treatment Trial identified that the risk factors for treatment failure included male sex, high-grade papilledema, low baseline visual acuity, and increased number of transient visual obscuration episodes per month. Among patients with these risk factors, the IIHTT recommends closer monitoring while considering more aggressive treatment options.

• #33 Idiopathic Intracranial Hypertension

  https://practicalneurology.com/diseases-diagnoses/headache-pain/idiopathic-intracranial-hypertension/31655/

  Treatment of idiopathic intracranial hypertension should be started as soon as diagnosis is confirmed to prevent vision loss. […] Once the diagnosis is confirmed, medical and surgical treatments, as well as lifestyle changes, should be implemented in order to prevent vision loss. […] The potential for vision loss requires timely identification and treatment of IIH. […] If left untreated, patients will continue to have constriction of visual fields and may progress to blindness due to optic disc edema and subsequent ischemia. […] Treatment of IIH is directed at lowering ICP in order to improve vision and headache. […] The management of IIH is multimodal and includes lifestyle measures (ie, diet and weight loss), medical therapy, and surgical procedures if medical treatment does not improve IIH.

• #34 Idiopathic Intracranial Hypertension: pseudotumor cerebri

  https://webeye.ophth.uiowa.edu/eyeforum/article/iih/pc-medical-tx.htm

  Weight loss is the cornerstone of therapy for idiopathic intracranial hypertension. We recommend a low salt, weight reduction diet with loss of about 5 – 10% of body weight followed by stable weight. This goal, of modest weight loss, is more likely to succeed than the usual aggressive weight loss program. […] In our experience, acetazolamide appears to be an effective treatment for idiopathic intracranial hypertension. We start the patient with a dose of 250 mg p.o. b.i.d. and increase the dose every four days by 250 mg until a dose of 1 gram a day is reached or the patient becomes intolerant to the side effects. If tolerated we give the medication twice daily with meals. If after one to two months there is no substantial improvement in visual function or symptoms, we gradually increase the dose to two grams per day. Doses of up to four grams a day may be needed but we usually obtain a beneficial effect in the one to two gram a day range. If acetazolamide is not well tolerated we use furosemide or topiramate. Modification of therapy is based on a combination of the patients symptoms, visual field examinations and changes in papilledema.

• #35 Idiopathic intracranial hypertension (pseudotumor cerebri): Prognosis and treatment – UpToDate

  https://www.uptodate.com/contents/idiopathic-intracranial-hypertension-pseudotumor-cerebri-prognosis-and-treatment

  Patients require regular ophthalmology follow-up visits until they stabilize. Follow-up visit intervals are individualized based on the severity, duration, and response to treatment of the clinical manifestations, but initially should be at least monthly in patients with moderate symptoms. […] A low-sodium weight reduction program, ideally in conjunction with a nutritionist or dietitian, is recommended for all patients with obesity and IIH. […] For initial treatment of patients with IIH, we suggest treatment with the carbonic anhydrase inhibitor acetazolamide. […] Patients with IIH can continue to have headaches despite improvement in papilledema and visual function. Medications used in the prophylactic treatment of migraine headaches are often used for headache management in IIH if other treatments described above are not effective in this regard.

• #36 Idiopathic Intracranial Hypertension (IIH) Treatment & Management: Approach Considerations, Pharmacologic Therapy, Optic Nerve Sheath Fenestration, CSF Diversion, and Venous Sinus Stenting

  https://emedicine.medscape.com/article/1214410-treatment

  The initial treatment typically involves administering acetazolamide, dosed according to the patient’s symptoms, tolerance, and visual function. If progressive visual field loss occurs despite maximal medical therapy, urgent surgical intervention may be necessary. […] Regular ophthalmologic assessments, especially quantitative visual field tests, are crucial to evaluate the effectiveness of the treatment plan. […] If vision deteriorates despite ongoing treatment, surgical options like optic nerve sheath fenestration, lumboperitoneal or ventriculoperitoneal shunting, or endovascular venous stenting should be considered. […] Identifying and addressing any underlying causes, including specific disorders or medications, is also critical to managing IIH effectively. […] Weight loss is a cornerstone in the long-term management of these patients. On initial diagnosis, a weight-reduction and low sodium diet should be strongly recommended to all patients. As little as a 5-10% weight loss has been demonstrated to yield a reduction in ICP with accompanying resolution of papilledema.

• #37 Pseudotumor Cerebri (Idiopathic Intracranial Hypertension) – EyeWiki

  https://eyewiki.org/Pseudotumor_Cerebri_(Idiopathic_Intracranial_Hypertension)

  Pseudotumor cerebri, also known as idiopathic intracranial hypertension (IIH), is a disorder characterized by increased intracranial pressure (ICP) of unknown cause that predominantly affects obese women of childbearing age. Papilledema is the primary ocular finding and may progressively lead to optic atrophy and blindness if no treatment is provided. Variable treatment options are available, but there are no formal guidelines with regards to therapeutic approach. […] The goal of treatment is to alleviate symptoms of ICP and preserve vision. Although diagnostic lumbar puncture may provide symptom relief the latter is often transient and requires combination with further long-term therapy. […] All obese patients should be encouraged to lose modest amount of weight. Among patients who are obese or overweight, weight loss of about 5-10% has been found to improve symptoms and signs. In a recent study, weight loss allowed a decrease in headaches, papilledema, and ICP. However, the latter option is not effective for acute symptomatic relief and management and therefore needs to be combined with further acute treatment.

• #38 Idiopathic intracranial hypertension doc – Bobby Jones CSF

  https://bobbyjonescsf.org/physician-information/idiopathic-intracranial-hypertension/

  The most commonly used medication for the initial treatment of IIH is acetazolamide. This powerful carbonic anhydrase inhibitor works by reducing secretion of spinal fluid by the choroid plexus within each brain ventricle. Acetazolamide was found to be effective in reducing symptoms in a randomized study of 165 patients with IIH. […] Repeated lumbar punctures with drainage of up to 30 to 40 cc of spinal fluid can improve IIH symptoms temporarily, sometimes for a month or more. Occasionally, the condition has been brought under remission following one lumbar puncture. […] If the body mass index is very high (BMI of 35kg/m2 or more) spinal fluid shunts fail so often that they are not advised. The current recommendation when the BMI is 35kg/m2 or greater is to consider bariatric surgery. […] In those patients with deteriorating vision facing the risk of blindness, fenestration of the optic nerve sheath can be considered. The procedure is performed through a brain operation or through an endoscope placed in the nose a procedure called an endonasal endoscopic optic nerve fenestration (ONSF). Small slits are performed in the optic nerve sheath to reduce the pressure on the nerve. ONSF has been found to improve vision in 59% and headache in 44%.

• #39 Idiopathic Intracranial Hypertension: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21968-idiopathic-intracranial-hypertension

  Some medicines can help you manage IIH symptoms. Your provider may prescribe: Acetazolamide or topiramate to help your body produce less CSF, A diuretic (water pill) to decrease fluid retention, Pain relievers for headaches. […] In severe cases, you may need surgery for IIH. Surgical options could include: A shunt, A stent, Optic nerve sheath fenestration. […] To prevent IIH from happening again, your provider may suggest making lifestyle changes to improve your overall health. This could include participating in a weight management program if you have a BMI over 30. […] Timely treatment at the first sign of vision changes or symptoms can help reduce your risk of complications like permanent vision loss. Treatment is often successful at relieving symptoms. […] Let a provider know if you notice symptoms of IIH (like a headache or ringing in your ears) with changes to your vision.

• #40 Idiopathic Intracranial Hypertension

  https://practicalneurology.com/diseases-diagnoses/headache-pain/idiopathic-intracranial-hypertension/31655/

  Medical management of IIH primarily utilizes carbonic anhydrase inhibitors including diuretics and antiseizure medication. […] Acetazolamide, a carbonic anhydrase inhibitor, has been used for the treatment of IIH for years based on studies that demonstrated efficacy for improving papilledema and vision, making acetazolamide an evidence-based first-line therapy. […] Obesity is associated with IIH and individuals with IIH who have a body mass index (BMI) greater than 40 kg/m2 are at higher risk for vision loss, making weight loss critical in the treatment of IIH. […] Surgical intervention should be considered for individuals who are at immediate risk of vision loss and have medically refractory disease. […] There are 3 main surgical options for IIH treatment. These include CSF-diverting procedures: LP or ventriculoperitoneal (VP) shunting, optic nerve sheath fenestration (ONSF), and venous sinus stenting.

• #41 A Second Helping

  https://www.reviewofoptometry.com/article/ro1117-a-second-helping

  The key goal is to decrease ICP to help preserve vision and eliminate intractable headaches. Medical therapies include acetazolamide, oral glycerol, IV mannitol and weight reduction. […] Acetazolamide is the treatment of choice to manage IIH. […] In IIH, medical management is necessary to preserve visual function and decrease systemic symptoms. Monthly follow up is recommended to test visual acuities, perform formal perimetry and record the grading of disc edema.

• #42 Idiopathic Intracranial Hypertension: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21968-idiopathic-intracranial-hypertension

  Some medicines can help you manage IIH symptoms. Your provider may prescribe: Acetazolamide or topiramate to help your body produce less CSF, A diuretic (water pill) to decrease fluid retention, Pain relievers for headaches. […] In severe cases, you may need surgery for IIH. Surgical options could include: A shunt, A stent, Optic nerve sheath fenestration. […] To prevent IIH from happening again, your provider may suggest making lifestyle changes to improve your overall health. This could include participating in a weight management program if you have a BMI over 30. […] Timely treatment at the first sign of vision changes or symptoms can help reduce your risk of complications like permanent vision loss. Treatment is often successful at relieving symptoms. […] Let a provider know if you notice symptoms of IIH (like a headache or ringing in your ears) with changes to your vision.

• #43 Idiopathic Intracranial Hypertension: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21968-idiopathic-intracranial-hypertension

  Some medicines can help you manage IIH symptoms. Your provider may prescribe: Acetazolamide or topiramate to help your body produce less CSF, A diuretic (water pill) to decrease fluid retention, Pain relievers for headaches. […] In severe cases, you may need surgery for IIH. Surgical options could include: A shunt, A stent, Optic nerve sheath fenestration. […] To prevent IIH from happening again, your provider may suggest making lifestyle changes to improve your overall health. This could include participating in a weight management program if you have a BMI over 30. […] Timely treatment at the first sign of vision changes or symptoms can help reduce your risk of complications like permanent vision loss. Treatment is often successful at relieving symptoms. […] Let a provider know if you notice symptoms of IIH (like a headache or ringing in your ears) with changes to your vision.

• #44 Idiopathic Intracranial Hypertension: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21968-idiopathic-intracranial-hypertension

  Some medicines can help you manage IIH symptoms. Your provider may prescribe: Acetazolamide or topiramate to help your body produce less CSF, A diuretic (water pill) to decrease fluid retention, Pain relievers for headaches. […] In severe cases, you may need surgery for IIH. Surgical options could include: A shunt, A stent, Optic nerve sheath fenestration. […] To prevent IIH from happening again, your provider may suggest making lifestyle changes to improve your overall health. This could include participating in a weight management program if you have a BMI over 30. […] Timely treatment at the first sign of vision changes or symptoms can help reduce your risk of complications like permanent vision loss. Treatment is often successful at relieving symptoms. […] Let a provider know if you notice symptoms of IIH (like a headache or ringing in your ears) with changes to your vision.

• #45 Pseudotumor Cerebri Treatment | UVA Health

  https://uvahealth.com/services/benign-brain-tumor/pseudotumor-cerebri

  Pseudotumor cerebri, also called idiopathic intracranial hypertension (IIH), is a condition in which the pressure inside your skull is too high. This pressure can cause symptoms similar to those of a brain tumor. Most people completely recover with treatment. […] Treatment focuses on: Symptom relief, Reducing pressure inside your skull, Preserving your vision. […] We have many different healthcare providers, including neurologists; neurosurgeons; ear, nose and throat specialists; and eye specialists, contributing to your diagnosis and care. […] Sometimes, this condition goes away without any treatment. […] Weve also found that, if youre overweight, losing weight and maintaining a low-sodium diet may help reduce pressure inside your skull. […] Treatment usually starts with medications to relieve pain. Youll also likely need medications that help reduce pressure in your skull, such as: Diuretics (decrease the general amount of body fluids), Acetazolamide (decreases the production of cerebrospinal fluid), Steroids (needed when vision loss happens quickly).

• #46 Idiopathic Intracranial Hypertension: pseudotumor cerebri

  https://webeye.ophth.uiowa.edu/eyeforum/article/iih/pc-medical-tx.htm

  Weight loss is the cornerstone of therapy for idiopathic intracranial hypertension. We recommend a low salt, weight reduction diet with loss of about 5 – 10% of body weight followed by stable weight. This goal, of modest weight loss, is more likely to succeed than the usual aggressive weight loss program. […] In our experience, acetazolamide appears to be an effective treatment for idiopathic intracranial hypertension. We start the patient with a dose of 250 mg p.o. b.i.d. and increase the dose every four days by 250 mg until a dose of 1 gram a day is reached or the patient becomes intolerant to the side effects. If tolerated we give the medication twice daily with meals. If after one to two months there is no substantial improvement in visual function or symptoms, we gradually increase the dose to two grams per day. Doses of up to four grams a day may be needed but we usually obtain a beneficial effect in the one to two gram a day range. If acetazolamide is not well tolerated we use furosemide or topiramate. Modification of therapy is based on a combination of the patients symptoms, visual field examinations and changes in papilledema.

• #47 Idiopathic intracranial hypertension (pseudotumor cerebri): Prognosis and treatment – UpToDate

  https://www.uptodate.com/contents/idiopathic-intracranial-hypertension-pseudotumor-cerebri-prognosis-and-treatment

  Treatment is urgent to preserve vision: Acetazolamide should be initiated promptly and can be rapidly titrated up to 4 grams per day divided into two doses. […] Patients with IIH who appear to benefit from surgical intervention include those who fail, are intolerant to, or are noncompliant with maximum medical therapy. […] The two main surgical procedures in IIH are optic nerve sheath fenestration (ONSF) and cerebrospinal fluid (CSF) shunting procedures. […] ONSF appears to be an effective procedure in patients who have progressive vision loss despite medical therapy. […] Permanent disabling vision loss is the major morbidity associated with IIH but is uncommon. […] A recurrence of symptoms may occur in 8 to 38 percent of patients after recovery from an episode of IIH or after a prolonged period of stability.

• #48 Interventions for idiopathic intracranial hypertension

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7173709/

  We have listed the adverse effects reported in Wall 2014. People in the acetalomazide group had an increased risk of decreased CO2, diarrhoea, dysgeusia, fatigue, nausea, paresthesia, tinnitus and vomiting compared to people in the placebo group. In general, the estimates of effect were uncertain with wide 95% CIs. Adverse effects were not reported in Ball 2011. […] Data from the Wall 2014 RCT indicated that quality of life was better in acetazolamide-treated patients based on the visual quality of life (VFQ25) and the physical and mental components of the 36-Item Short Form Health Survey tool at six months.

• #49 Interventions for idiopathic intracranial hypertension

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7173709/

  We have listed the adverse effects reported in Wall 2014. People in the acetalomazide group had an increased risk of decreased CO2, diarrhoea, dysgeusia, fatigue, nausea, paresthesia, tinnitus and vomiting compared to people in the placebo group. In general, the estimates of effect were uncertain with wide 95% CIs. Adverse effects were not reported in Ball 2011. […] Data from the Wall 2014 RCT indicated that quality of life was better in acetazolamide-treated patients based on the visual quality of life (VFQ25) and the physical and mental components of the 36-Item Short Form Health Survey tool at six months.

• #50 Idiopathic intracranial hypertension doc – Bobby Jones CSF

  https://bobbyjonescsf.org/physician-information/idiopathic-intracranial-hypertension/

  The most commonly used medication for the initial treatment of IIH is acetazolamide. This powerful carbonic anhydrase inhibitor works by reducing secretion of spinal fluid by the choroid plexus within each brain ventricle. Acetazolamide was found to be effective in reducing symptoms in a randomized study of 165 patients with IIH. […] Repeated lumbar punctures with drainage of up to 30 to 40 cc of spinal fluid can improve IIH symptoms temporarily, sometimes for a month or more. Occasionally, the condition has been brought under remission following one lumbar puncture. […] If the body mass index is very high (BMI of 35kg/m2 or more) spinal fluid shunts fail so often that they are not advised. The current recommendation when the BMI is 35kg/m2 or greater is to consider bariatric surgery. […] In those patients with deteriorating vision facing the risk of blindness, fenestration of the optic nerve sheath can be considered. The procedure is performed through a brain operation or through an endoscope placed in the nose a procedure called an endonasal endoscopic optic nerve fenestration (ONSF). Small slits are performed in the optic nerve sheath to reduce the pressure on the nerve. ONSF has been found to improve vision in 59% and headache in 44%.

• #51 Idiopathic Intracranial Hypertension in a 24-Year-Old Woman | MDedge Emergency Medicine

  https://www.mdedge9-ma1.mdedge.com/emergencymedicine/article/130590/pain/idiopathic-intracranial-hypertension-24-year-old-woman

  Not every patient with IIH experiences amelioration or resolution of symptoms following an LP; moreover, there is no clear way to differentiate patients who will experience therapeutic effects from LP from those who will not. Serial LPs as treatment for IIH have been discussed in the literature, but a ventriculoperitoneal shunt is a more practical approach in patients who do not respond to an initial LP.2,14 […] The accepted first-line medication to alleviate symptoms of IIH is acetazolamide, and its use is supported by a recent randomized controlled trial conducted by the Neuro-Ophthalmology Research Disease Investigator Consortium (NORDIC).22 Most neurologists will administer a starting dose of acetazolamide 500 mg twice a day, and then increase the dose until symptoms are controlled or adverse effects appear (eg, fatigue, nausea/vomiting/diarrhea, electrolyte abnormalities, kidney stones) that contraindicate further dosage increases. In the NORDIC trial, patients were given up to 4 g of acetazolamide daily.22 […] A patient who fails conservative treatment should be referred to a neurosurgeon for placement of a CSF shunt, optic nerve sheath fenestration, or placement of a venous sinus stent.23

• #52 Idiopathic Intracranial Hypertension

  https://practicalneurology.com/diseases-diagnoses/headache-pain/idiopathic-intracranial-hypertension/31655/

  Medical management of IIH primarily utilizes carbonic anhydrase inhibitors including diuretics and antiseizure medication. […] Acetazolamide, a carbonic anhydrase inhibitor, has been used for the treatment of IIH for years based on studies that demonstrated efficacy for improving papilledema and vision, making acetazolamide an evidence-based first-line therapy. […] Obesity is associated with IIH and individuals with IIH who have a body mass index (BMI) greater than 40 kg/m2 are at higher risk for vision loss, making weight loss critical in the treatment of IIH. […] Surgical intervention should be considered for individuals who are at immediate risk of vision loss and have medically refractory disease. […] There are 3 main surgical options for IIH treatment. These include CSF-diverting procedures: LP or ventriculoperitoneal (VP) shunting, optic nerve sheath fenestration (ONSF), and venous sinus stenting.

• #53 Idiopathic intracranial hypertension (pseudotumor cerebri): Prognosis and treatment – UpToDate

  https://www.uptodate.com/contents/idiopathic-intracranial-hypertension-pseudotumor-cerebri-prognosis-and-treatment/print

  Patients with IIH who appear to benefit from surgical intervention include those who fail, are intolerant to, or are noncompliant with maximum medical therapy. […] The two main surgical procedures in IIH are optic nerve sheath fenestration (ONSF) and cerebrospinal fluid (CSF) shunting procedures. […] The major morbidity associated with idiopathic intracranial hypertension (IIH) is vision loss. As much as 15 percent of individuals with IIH may be at risk of severe, permanent vision loss.

• #54 Idiopathic Intracranial Hypertension

  https://practicalneurology.com/diseases-diagnoses/headache-pain/idiopathic-intracranial-hypertension/31655/

  Medical management of IIH primarily utilizes carbonic anhydrase inhibitors including diuretics and antiseizure medication. […] Acetazolamide, a carbonic anhydrase inhibitor, has been used for the treatment of IIH for years based on studies that demonstrated efficacy for improving papilledema and vision, making acetazolamide an evidence-based first-line therapy. […] Obesity is associated with IIH and individuals with IIH who have a body mass index (BMI) greater than 40 kg/m2 are at higher risk for vision loss, making weight loss critical in the treatment of IIH. […] Surgical intervention should be considered for individuals who are at immediate risk of vision loss and have medically refractory disease. […] There are 3 main surgical options for IIH treatment. These include CSF-diverting procedures: LP or ventriculoperitoneal (VP) shunting, optic nerve sheath fenestration (ONSF), and venous sinus stenting.

• #55 Idiopathic intracranial hypertension doc – Bobby Jones CSF

  https://bobbyjonescsf.org/physician-information/idiopathic-intracranial-hypertension/

  The most commonly used medication for the initial treatment of IIH is acetazolamide. This powerful carbonic anhydrase inhibitor works by reducing secretion of spinal fluid by the choroid plexus within each brain ventricle. Acetazolamide was found to be effective in reducing symptoms in a randomized study of 165 patients with IIH. […] Repeated lumbar punctures with drainage of up to 30 to 40 cc of spinal fluid can improve IIH symptoms temporarily, sometimes for a month or more. Occasionally, the condition has been brought under remission following one lumbar puncture. […] If the body mass index is very high (BMI of 35kg/m2 or more) spinal fluid shunts fail so often that they are not advised. The current recommendation when the BMI is 35kg/m2 or greater is to consider bariatric surgery. […] In those patients with deteriorating vision facing the risk of blindness, fenestration of the optic nerve sheath can be considered. The procedure is performed through a brain operation or through an endoscope placed in the nose a procedure called an endonasal endoscopic optic nerve fenestration (ONSF). Small slits are performed in the optic nerve sheath to reduce the pressure on the nerve. ONSF has been found to improve vision in 59% and headache in 44%.

• #56 Idiopathic intracranial hypertension doc – Bobby Jones CSF

  https://bobbyjonescsf.org/physician-information/idiopathic-intracranial-hypertension/

  IIH patients found to have stenosis (narrowing) of one of the venous sinuses in the brain are considered for dilation or stenting of the narrowed segment. Through a catheter placed in the large vein next to the groin, a catheter is navigated to the site of the venous sinus stenosis and the narrowing is dilated or stented as indicated.

• #57 Idiopathic intracranial hypertension (pseudotumor cerebri): Prognosis and treatment – UpToDate

  https://www.uptodate.com/contents/idiopathic-intracranial-hypertension-pseudotumor-cerebri-prognosis-and-treatment

  Treatment is urgent to preserve vision: Acetazolamide should be initiated promptly and can be rapidly titrated up to 4 grams per day divided into two doses. […] Patients with IIH who appear to benefit from surgical intervention include those who fail, are intolerant to, or are noncompliant with maximum medical therapy. […] The two main surgical procedures in IIH are optic nerve sheath fenestration (ONSF) and cerebrospinal fluid (CSF) shunting procedures. […] ONSF appears to be an effective procedure in patients who have progressive vision loss despite medical therapy. […] Permanent disabling vision loss is the major morbidity associated with IIH but is uncommon. […] A recurrence of symptoms may occur in 8 to 38 percent of patients after recovery from an episode of IIH or after a prolonged period of stability.

• #58 Idiopathic intracranial hypertension doc – Bobby Jones CSF

  https://bobbyjonescsf.org/physician-information/idiopathic-intracranial-hypertension/

  The most commonly used medication for the initial treatment of IIH is acetazolamide. This powerful carbonic anhydrase inhibitor works by reducing secretion of spinal fluid by the choroid plexus within each brain ventricle. Acetazolamide was found to be effective in reducing symptoms in a randomized study of 165 patients with IIH. […] Repeated lumbar punctures with drainage of up to 30 to 40 cc of spinal fluid can improve IIH symptoms temporarily, sometimes for a month or more. Occasionally, the condition has been brought under remission following one lumbar puncture. […] If the body mass index is very high (BMI of 35kg/m2 or more) spinal fluid shunts fail so often that they are not advised. The current recommendation when the BMI is 35kg/m2 or greater is to consider bariatric surgery. […] In those patients with deteriorating vision facing the risk of blindness, fenestration of the optic nerve sheath can be considered. The procedure is performed through a brain operation or through an endoscope placed in the nose a procedure called an endonasal endoscopic optic nerve fenestration (ONSF). Small slits are performed in the optic nerve sheath to reduce the pressure on the nerve. ONSF has been found to improve vision in 59% and headache in 44%.

• #59 Diagnosing and Treating Pseudotumor Cerebri | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/pseudotumor-cerebri/diagnosing-and-treating-pseudotumor-cerebri

  An innovative procedure performed at Weill Cornell Medicine has shown promising results for patients with venous sinus stenosis. Venous sinus stenting is a minimally invasive procedure treatment appropriate for patients who have venous sinus stenosis on MRI or CT and involves the placement of a stent (mesh in the shape of a tube) in one of the narrowed veins in the brain, via small incisions in the groin area. Relieving the stenosis (narrowing) may relieve the increased pressure and alleviate symptoms.

• #60 DigitalCommons@PCOM – Research Day: A holistic approach to idiopathic intracranial hypertension treatment and management

  https://digitalcommons.pcom.edu/research_day/research_day_GA_2024/researchGA2024/55/

  Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri or benign intracranial hypertension, is a neurological condition characterized by elevated intracranial pressure, leading to headache, tinnitus, and transient visual loss. […] The initial presentation of IIH, especially for those experiencing it for the first time, can be distressing and traumatic. The psychological repercussions of an IIH diagnosis and its subsequent treatment can be detrimental, often leading to depression and anxiety in affected individuals. […] However, a more inclusive and holistic approach to IIH management is crucial. It is imperative to recognize that each patient is unique and should not be reduced to a statistical consideration. Effective IIH management requires a comprehensive care team to ensure that the patient feels supported in all aspects of health management. This approach should have a PCP serving as the center of a coordinated care model encompassing various resources (e.g., mental health professionals, dietitians, osteopathic manipulative treatment.) Emphasizing the importance of a holistic strategy that addresses both mental and physical aspects of the disease can improve positive outcomes in patient care and disease management.

• #61 DigitalCommons@PCOM – Research Day: A holistic approach to idiopathic intracranial hypertension treatment and management

  https://digitalcommons.pcom.edu/research_day/research_day_GA_2024/researchGA2024/55/

  Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri or benign intracranial hypertension, is a neurological condition characterized by elevated intracranial pressure, leading to headache, tinnitus, and transient visual loss. […] The initial presentation of IIH, especially for those experiencing it for the first time, can be distressing and traumatic. The psychological repercussions of an IIH diagnosis and its subsequent treatment can be detrimental, often leading to depression and anxiety in affected individuals. […] However, a more inclusive and holistic approach to IIH management is crucial. It is imperative to recognize that each patient is unique and should not be reduced to a statistical consideration. Effective IIH management requires a comprehensive care team to ensure that the patient feels supported in all aspects of health management. This approach should have a PCP serving as the center of a coordinated care model encompassing various resources (e.g., mental health professionals, dietitians, osteopathic manipulative treatment.) Emphasizing the importance of a holistic strategy that addresses both mental and physical aspects of the disease can improve positive outcomes in patient care and disease management.

• #62 DigitalCommons@PCOM – Research Day: A holistic approach to idiopathic intracranial hypertension treatment and management

  https://digitalcommons.pcom.edu/research_day/research_day_GA_2024/researchGA2024/55/

  Until further research sheds light on the underlying pathophysiology of IIH, the focus should shift towards establishing holistic treatment protocols and developing multifaceted care teams to promote the best outcomes for patients. This approach will empower patients and allow them to foster a sense of control in the face of this challenging condition.

• #63 Idiopathic intracranial hypertension (pseudotumor cerebri): Prognosis and treatment – UpToDate

  https://www.uptodate.com/contents/idiopathic-intracranial-hypertension-pseudotumor-cerebri-prognosis-and-treatment/print

  Patients with IIH who appear to benefit from surgical intervention include those who fail, are intolerant to, or are noncompliant with maximum medical therapy. […] The two main surgical procedures in IIH are optic nerve sheath fenestration (ONSF) and cerebrospinal fluid (CSF) shunting procedures. […] The major morbidity associated with idiopathic intracranial hypertension (IIH) is vision loss. As much as 15 percent of individuals with IIH may be at risk of severe, permanent vision loss.

• #64 Idiopathic Intracranial Hypertension

  https://practicalneurology.com/diseases-diagnoses/headache-pain/idiopathic-intracranial-hypertension/31655/

  Despite improving visual outcomes by reducing ICP, many people with IIH continue to have disabling headache even after ICP returns to normal. […] Ultimately, treatment of headache in IIH is based on the headache phenotype, which is typically migrainous, and data on specific therapies for headache in IIH are limited.

• #65 Idiopathic Intracranial Hypertension

  https://practicalneurology.com/diseases-diagnoses/headache-pain/idiopathic-intracranial-hypertension/31655/

  Despite improving visual outcomes by reducing ICP, many people with IIH continue to have disabling headache even after ICP returns to normal. […] Ultimately, treatment of headache in IIH is based on the headache phenotype, which is typically migrainous, and data on specific therapies for headache in IIH are limited.

• #66 Pseudotumor Cerebri (PCT) | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/pseudotumor-cerebri-pct

  Pseudotumor cerebri (SOO-doe-too-mur SER-ree-bry) (PTC) is also known as idiopathic intracranial hypertension (IIH). It is a disease that causes increased pressure in the brain. […] The increased intracranial pressure can put pressure on the optic nerve which can cause vision loss. If treated early, vision loss can be prevented. If it is not treated quickly, permanent vision loss and chronic pain due to headaches may occur. […] The most common ways to treat PTC are weight loss if needed, and acetazolamide (Diamox) or furosemide. These are water pills (diuretics) that help the body lose fluid. […] In 2 out of 3 children, when the PTC goes away, they will get consistent headaches. These headaches can differ from the headaches they got when diagnosed with PTC. This is one reason it is important to keep follow-up appointments with their health care provider and the neurology team.

• #67 Idiopathic intracranial hypertension (pseudotumor cerebri): Prognosis and treatment – UpToDate

  https://www.uptodate.com/contents/idiopathic-intracranial-hypertension-pseudotumor-cerebri-prognosis-and-treatment

  Treatment is urgent to preserve vision: Acetazolamide should be initiated promptly and can be rapidly titrated up to 4 grams per day divided into two doses. […] Patients with IIH who appear to benefit from surgical intervention include those who fail, are intolerant to, or are noncompliant with maximum medical therapy. […] The two main surgical procedures in IIH are optic nerve sheath fenestration (ONSF) and cerebrospinal fluid (CSF) shunting procedures. […] ONSF appears to be an effective procedure in patients who have progressive vision loss despite medical therapy. […] Permanent disabling vision loss is the major morbidity associated with IIH but is uncommon. […] A recurrence of symptoms may occur in 8 to 38 percent of patients after recovery from an episode of IIH or after a prolonged period of stability.

• #68 Intracranial Hypertension (Pseudotumor Cerebri): Diagnosis & Treatment | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/intracranial-hypertension-pseudotumor-cerebri

  Idiopathic intracranial hypertension, sometimes called pseudotumor cerebri, is a condition in which the cerebro-spinal fluid is not able to drain normally. […] The ophthalmologist will closely monitor your child’s vision and the nerve swelling. Medicines to lower the pressure and bring down the nerve swelling are the most common treatment. […] The most important thing anyone can do to improve this condition is to maintain a healthy weight, or lose weight if obese. […] If treated, the outcome is good. If not treated, permanent blindness can occur.

• #69 Idiopathic Intracranial Hypertension – Child Neurology Foundation

  https://www.childneurologyfoundation.org/disorder/idiopathic-intracranial-hypertension/

  If pressure remains elevated, a shunt (a special tube) can drain fluid from the brain. This can be placed by neurosurgeons. […] With treatment, there is typically a gradual improvement in vision with minimal, if any, vision loss. Cases where vision loss is significant or permanent are uncommon in IIH. […] It is important for patients to have yearly follow-up eye exams.

• #70 Pseudotumor Cerebri – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK536924/

  Pseudotumor cerebri (PTC), also known as idiopathic intracranial hypertension (IIH), is a disorder with increased intracranial pressure (ICP) and associated headaches, papilledema, vision changes, or pulsatile tinnitus in the setting of normal imaging and cerebrospinal fluid (CSF) studies. It mainly affects overweight women of childbearing age. This activity reviews the cause and pathophysiology of pseudotumor cerebri and highlights the role of the interprofessional team in its management. […] Nurses should be aware of pupillary changes that often occur with an elevation of intracranial pressure. A prompt referral to a neurologist/neurosurgeon is necessary when the patient has unequal pupils, papilledema, and/or focal neurological deficits.

• #71

  https://www.nursingcenter.com/journalarticle?Article_ID=3872252&Journal_ID=828525&Issue_ID=3872209

  ABSTRACT: Idiopathic intracranial hypertension has been recognized in the literature for over 100 years. It is a disease of elevated intracranial pressure without evidence of a space-occupying lesion found most often in obese women of childbearing age. The signs and symptoms have been well described; however, the etiology is yet unknown. Medical and surgical treatment is aimed at the preservation of vision and improvement in symptoms. The medical literature is replete with articles addressing the epidemiology, pathophysiology, clinical and imaging features, and treatment. There are limited nursing reports (Lehman, 2003; McDonald, 1984; Revta, 1977). The objective of this manuscript is to provide an overview for the neuroscience nurse of the clinical features, diagnostic work-up, and therapeutic options available for patients with idiopathic intracranial hypertension.

• #72 DigitalCommons@PCOM – Research Day: A holistic approach to idiopathic intracranial hypertension treatment and management

  https://digitalcommons.pcom.edu/research_day/research_day_GA_2024/researchGA2024/55/

  Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri or benign intracranial hypertension, is a neurological condition characterized by elevated intracranial pressure, leading to headache, tinnitus, and transient visual loss. […] The initial presentation of IIH, especially for those experiencing it for the first time, can be distressing and traumatic. The psychological repercussions of an IIH diagnosis and its subsequent treatment can be detrimental, often leading to depression and anxiety in affected individuals. […] However, a more inclusive and holistic approach to IIH management is crucial. It is imperative to recognize that each patient is unique and should not be reduced to a statistical consideration. Effective IIH management requires a comprehensive care team to ensure that the patient feels supported in all aspects of health management. This approach should have a PCP serving as the center of a coordinated care model encompassing various resources (e.g., mental health professionals, dietitians, osteopathic manipulative treatment.) Emphasizing the importance of a holistic strategy that addresses both mental and physical aspects of the disease can improve positive outcomes in patient care and disease management.

• #73 Pseudotumor cerebri (idiopathic intracranial hypertension) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudotumor-cerebri/diagnosis-treatment/drc-20354036

  The goal of pseudotumor cerebri treatment is to improve your symptoms and keep your eyesight from worsening. […] If you’re obese, your doctor might recommend a low-sodium weight-loss diet to help improve your symptoms. You might work with a dietitian to help with your weight-loss goals. Some people benefit from weight-loss programs or gastric surgery. […] Losing extra pounds and maintaining a healthy weight might help reduce your chances of developing this potentially sight-stealing disorder. […] Once you’ve had pseudotumor cerebri, you’ll need to have your vision checked regularly to monitor changes.

• #74 Idiopathic Intracranial Hypertension: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21968-idiopathic-intracranial-hypertension

  Idiopathic intracranial hypertension (IIH) is increased pressure in your skull. It occurs because of cerebrospinal fluid buildup around your brain. The cause is unknown. It can affect your vision and cause headaches, nausea or ringing in your ears. Treatments are available. […] Let a healthcare provider know if you notice symptoms like changes to your vision in addition to a headache or ringing in your ears. Treatment options are available for IIH. […] IIH may lead to vision loss if untreated. This is irreversible. A healthcare provider can offer treatment options to prevent this complication, so let them know as soon as possible if you notice changes to your vision. […] The goals of IIH treatment are to decrease pressure on your brain and prevent vision loss. Depending on the severity, your healthcare provider may recommend: Taking medications, Undergoing surgery, Weight management.

• #75 Idiopathic Intracranial Hypertension | UC Health | Symptoms

  https://www.uchealth.com/en/conditions/idiopathic-intracranial-hypertension

  Idiopathic intracranial hypertension, or pseudotumor cerebri, is a disorder that is caused by a buildup of pressure from too much cerebrospinal fluid in the brain. […] The symptoms of IIH mimic those of a true brain tumor. The main sign is unusually high pressure inside the skull. This is known as intracranial hypertension. […] Treatment can vary based on what is causing the fluid to build up inside the skull. Treatment options include: Losing weight, if needed. Limiting fluids or salt in the diet. Taking medicines, such as water pills (diuretics). These help the body to get rid of extra fluid. […] Untreated IIH can result in permanent problems such as vision loss. Have regular eye exams and checkups treat any eye problems before they get worse. […] Any changes in vision should be checked out by a healthcare provider right away. Diagnosis and treatment can help prevent long-term complications such as vision loss.

• #76 Idiopathic Intracranial Hypertension | Barrow Neurological InstituteGroup 9Group 49

  https://www.barrowneuro.org/condition/idiopathic-intracranial-hypertension/

  Close monitoring of vision and optic nerve swelling is vital in IIH, as vision loss can be permanent and complete blindness can occur. If there are rapid changes in vision or the appearance of the optic nerves, treatment needs to be changed quickly. Sometimes the patient doesn’t notice vision changes that are picked up on the formal testing, so it is important to see the neuro-ophthalmologist or ophthalmologist for this testing as recommended.

• #77 Idiopathic Intracranial Hypertension | UC Health | Symptoms

  https://www.uchealth.com/en/conditions/idiopathic-intracranial-hypertension

  Idiopathic intracranial hypertension, or pseudotumor cerebri, is a disorder that is caused by a buildup of pressure from too much cerebrospinal fluid in the brain. […] The symptoms of IIH mimic those of a true brain tumor. The main sign is unusually high pressure inside the skull. This is known as intracranial hypertension. […] Treatment can vary based on what is causing the fluid to build up inside the skull. Treatment options include: Losing weight, if needed. Limiting fluids or salt in the diet. Taking medicines, such as water pills (diuretics). These help the body to get rid of extra fluid. […] Untreated IIH can result in permanent problems such as vision loss. Have regular eye exams and checkups treat any eye problems before they get worse. […] Any changes in vision should be checked out by a healthcare provider right away. Diagnosis and treatment can help prevent long-term complications such as vision loss.

• #78 Idiopathic Intracranial Hypertension: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21968-idiopathic-intracranial-hypertension

  Idiopathic intracranial hypertension (IIH) is increased pressure in your skull. It occurs because of cerebrospinal fluid buildup around your brain. The cause is unknown. It can affect your vision and cause headaches, nausea or ringing in your ears. Treatments are available. […] Let a healthcare provider know if you notice symptoms like changes to your vision in addition to a headache or ringing in your ears. Treatment options are available for IIH. […] IIH may lead to vision loss if untreated. This is irreversible. A healthcare provider can offer treatment options to prevent this complication, so let them know as soon as possible if you notice changes to your vision. […] The goals of IIH treatment are to decrease pressure on your brain and prevent vision loss. Depending on the severity, your healthcare provider may recommend: Taking medications, Undergoing surgery, Weight management.

• #79 DigitalCommons@PCOM – Research Day: A holistic approach to idiopathic intracranial hypertension treatment and management

  https://digitalcommons.pcom.edu/research_day/research_day_GA_2024/researchGA2024/55/

  Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri or benign intracranial hypertension, is a neurological condition characterized by elevated intracranial pressure, leading to headache, tinnitus, and transient visual loss. […] The initial presentation of IIH, especially for those experiencing it for the first time, can be distressing and traumatic. The psychological repercussions of an IIH diagnosis and its subsequent treatment can be detrimental, often leading to depression and anxiety in affected individuals. […] However, a more inclusive and holistic approach to IIH management is crucial. It is imperative to recognize that each patient is unique and should not be reduced to a statistical consideration. Effective IIH management requires a comprehensive care team to ensure that the patient feels supported in all aspects of health management. This approach should have a PCP serving as the center of a coordinated care model encompassing various resources (e.g., mental health professionals, dietitians, osteopathic manipulative treatment.) Emphasizing the importance of a holistic strategy that addresses both mental and physical aspects of the disease can improve positive outcomes in patient care and disease management.

• #80 DigitalCommons@PCOM – Research Day: A holistic approach to idiopathic intracranial hypertension treatment and management

  https://digitalcommons.pcom.edu/research_day/research_day_GA_2024/researchGA2024/55/

  Until further research sheds light on the underlying pathophysiology of IIH, the focus should shift towards establishing holistic treatment protocols and developing multifaceted care teams to promote the best outcomes for patients. This approach will empower patients and allow them to foster a sense of control in the face of this challenging condition.

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