iich
Table of Contents
benign raised idiopathic intracranial hypertension
see also:
Introduction
- aka pseudotumor cerebri
- a cause of chronic headache
Epidemiology
- increasingly common
Aetiology / risk factors
- most commonly occurs in overweight young women
Clinical features
- chronic headaches
- may have papilloedema
- some may develop thing of skull bone resulting in a CSF leak causing severe postural headaches
Radiographic features on CT brain
- slit-like ventricles
- other radiologic features that are suggestive of this cause1):
- optic nerve sheath distension
- posterior globe flattening
- optic nerve tortuosity in vertical or horizontal planes
- papilledema/optic nerve head protrusion
- optic nerve head enhancement
- Meckel cave enlargement
- arachnoid pits (aberrant arachnoid granulations) / small meningoceles, typically within the temporal bone and sphenoid wing
- enlarged oculomotor cistern
- prominent perivascular spaces
- transverse sinus stenosis
- acquired cerebellar tonsillar ectopia
- increased subcutaneous fat thickness in the scalp and neck (a slim patient is unlikely to develop idiopathic intracranial hypertension)
Diagnosis
- confirmed with raised LP opening pressures > 20mm water
Mx
iich.txt · Last modified: 2026/06/18 02:50 by gary1