What is idiopathic intracranial hypertension?

Idiopathic intracranial hypertension (IIH) is a disorder related to high pressure in the brain. It causes signs and symptoms of a brain tumor. It’s also sometimes called pseudotumor cerebri or benign intracranial hypertension.

The fluid that surrounds the spinal cord and brain is called cerebrospinal fluid or CSF. If too much fluid is made or not enough is re-absorbed, the CSF can build up. This can cause symptoms like those of a brain tumor. 

What causes idiopathic intracranial hypertension?

Experts don’t know why IIH occurs. Obesity is a risk factor. Some medicines have been linked to a higher risk of it. These include common medicines like:

• Birth control pills
• Certain antibiotics
• Chemotherapy medicines
• Steroids
• Some acne medicines

What are the symptoms of idiopathic intracranial hypertension?

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.

Other symptoms include:

• Changes in eyesight such as blurry vision or double vision
• Vision loss, especially in the peripheral vision
• Feeling dizzy or nauseated
• Vomiting
• Neck stiffness
• Trouble walking
• Frequent headaches, often along with nausea or vomiting
• Persistent ringing in the ears (tinnitus)
• Forgetfulness
• Depression

These symptoms may look like other health problems. Always see your healthcare provider for a diagnosis. 

You may find that certain symptoms increase when you’re exerting yourself. Exercise tends to raise the pressure in the skull.

Who is at risk for idiopathic intracranial hypertension?

Anyone can develop IIH. But some people are at higher risk for it, such as:

• Women of childbearing age (20 to 45 years)
• Overweight people
• People who have a thyroid condition or chronic kidney failure

How is idiopathic intracranial hypertension diagnosed?

A physical exam and a few tests can help identify IIH. Diagnosis involves ruling out other health problems, including a brain tumor. You may need these tests:

• Brain imaging such as MRI or CT scans
• Spinal tap (lumbar puncture) to withdraw a sample of fluid from around the spine for testing pressure
• Exam to test vision and check the back of your eye

How is idiopathic intracranial hypertension treated?

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
• Surgically putting a special tube (shunt) in the brain to drain fluid and ease pressure
• Having a spinal tap done to remove fluid and reduce pressure
• Taking medicines, such as water pills (diuretics). These help the body get rid of extra fluid.
• Having surgery on the optic nerve to ease pressure and save vision

What are possible complications of idiopathic intracranial hypertension?

Untreated IIH can result in permanent problems such as vision loss. Have regular eye exams and checkups to treat any eye problems before they get worse.

It’s also possible for symptoms to occur again even after treatment. It’s important to get regular checkups to help monitor symptoms and screen for an underlying problem.

Can idiopathic intracranial hypertension be prevented?

Obesity has been linked to IIH. So eating a healthy, low-fat diet and getting plenty of exercise may help reduce your risk for the condition. Losing weight is very hard, but don’t give up. If these strategies don’t help you lose weight. ask your healthcare provider for help and support.

When should I call my healthcare provider?

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.

Key points about idiopathic intracranial hypertension

• Idiopathic intracranial hypertension is a disorder related to high pressure in the brain.
• Even though IIH isn’t a brain tumor, it can still cause serious health problems.
• Seeing a healthcare provider right away to promptly diagnose symptoms and begin treatment can help to prevent complications.
• Eating a healthy, low-fat diet and getting plenty of exercise may help reduce your risk for IIH.