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Idiopathic intracranial hypertension is a condition where pressure and cerebrospinal fluid increase in the brain, causing migraines and vision problems. The cause is unknown, but risk factors include obesity, steroid use, and family history. Treatment includes lifestyle changes, medication, and surgery.
Idiopathic intracranial hypertension refers to an increase in the amount of pressure and cerebrospinal fluid (CSF) in the brain. High blood pressure can cause significant migraines and vision problems, sometimes leading to partial or total blindness. The disorder is not well understood, and doctors have not discovered an underlying cause. Drugs to slow CSF production and to remove excess fluid from the skull are effective in treating mild cases of idiopathic intracranial hypertension, although very large increases in pressure often require surgery.
While the exact causes of idiopathic intracranial hypertension are unknown, researchers have identified several risk factors. Women are about 90 percent more likely to develop the condition than men, and most patients are between the ages of 20 and 40. Obesity greatly increases the risk, and many people have family histories of complications of intracranial hypertension. Long-term use of steroids, birth control pills, lithium, and many other drugs also appear to increase the likelihood of developing the condition.
In most cases, symptoms of idiopathic intracranial hypertension develop slowly over several weeks to months. A person may have frequent or constant dull headaches that are centralized behind the eyes. A ringing in the ears and a throbbing, throbbing sensation in the temples are common as the disorder gets worse. Pressure on the optic nerve can cause blurred or blurred peripheral vision and induce nausea, dizziness, and vomiting. Without treatment, headaches and vision loss tend to become more debilitating and can lead to blindness.
A diagnosis of idiopathic intracranial hypertension is made only after doctors have ruled out all other possible causes of the symptoms. Imaging tests such as computed tomography are done to check for physical problems, including brain tumors, bruises, and aneurysms. Blood is drawn to look for signs of leukemia or infection, and an eye test is used to confirm the presence of swelling in the back of the eye along the optic nerve. A doctor may also decide to perform a lumbar puncture along the spine to collect a sample of cerebrospinal fluid and measure the severity of the intracranial pressure.
Once other conditions have been ruled out, treatment decisions can be discussed with the patient. Diet and exercise are usually important elements of treatment for obese patients, and many people see improvements in their symptoms within weeks of making better lifestyle choices. Corticosteroids or glaucoma medications may be prescribed to relieve swelling of the optic nerve. Surgery is considered if vision problems and other symptoms worsen despite medical treatment.
A procedure called optic nerve sheath fenestration can usually relieve pressure in the skull by creating a slit in the optic nerve for CSF drainage. A surgeon may also consider inserting a shunt that runs from the skull to the abdominal cavity. The shunt promotes constant drainage of cerebrospinal fluid, ensuring that pressure does not build up again. Most patients who receive surgical care are able to fully recover from symptoms.
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