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Idiopathic Intracranial Hypertension is a specific condition characterized by high pressure in the fluid around the brain. It is also known as pseudotumor cerebri which literally means false brain tumor, because it's symptoms mimic those of brain tumors.

The space around the brain is filled with water-like fluid called liquor! If there is too much of this fluid present, the pressure around the brain rises. This can't be avoided because the space containing the fluid cannot expand.

Incidence

Idiopathic Intracranial Hypertension is a very rare condition. It mostly affects women, particularly obese women in pre-menopausal period, but can also occur in men and children. Studies of American-based populations have estimated that the incidence of pseudotumor cerebri ranges from 0.9-1.0 per 100,000 in the general population.

Possible causes of benign intracranial hypertension

Many conditions have been linked to high intracranial pressure. In fact, any disorder that blocks the flow of spinal fluid between the brain and its route to the blood, the jugular vein, can cause raised pressure. The exact causes for this condition are still unclear, but can often be associated with:

  • menstrual problems,
  • hormonal problems,
  • being overweight,
  • certain medications - oral contraceptive and vitamin A, as well as steroid withdrawal

Symptoms of pseudotumor cerebri

Some of the most common symptoms are:

Headaches (94%)
Headache is present in nearly all patients with Idiopathic intracranial hypertension and it is usually severe and present on a daily basis.
They are different from the headaches that healthy people may experience because they may awaken the patient and usually last for hours. They are commonly accompanied with nausea and patients often describe it as the worst head pain ever experienced.

Transient visual obscurations or blurring (68%)
Transient visual obscurations are episodes of transient blurred vision that usually last less than 30 seconds and are followed by full recovery of vision. Visual obscurations occur in about 3/4 of IIH patients. The attacks may involve one or both eyes. They are not correlated with the degree of intracranial hypertension or with the extent of optic nerve swelling. Visual obscurations do not appear to be associated with poor visual outcome.

Pulse synchronous tinnitus in the ear (58%)
Pulse intracranial noises or pulse-synchronous tinnitus is a very common symptom of intracranial hypertension. In patients with intracranial hypertension, compression of the jugular vein on the side of sound abolishes it.

Double vision (38%)
Patients who who experience double vision due to IIH most frequently complain of horizontal displacement of the images. 

Other symptoms:

  • Pain behind the eye (44%)
  • Visual loss (30%)
  • Pain with eye movement (22%)
  • Shoulder and/or neck pain
  • Vomiting
  • Memory problems
  • Migraine attacks with unexplained triggers

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