What is Idiopathic Intracranial Hypertension (IIH)

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Last updated: April 26, 2025View editorial policy

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From the Guidelines

IIAH stands for Idiopathic Intracranial Hypertension, not Idiopathic Intracranial Arterial Hypertrophy, which is a condition characterized by raised intracranial pressure of unknown aetiology, as defined by the criteria set out in the consensus guidelines on management 1.

Definition and Diagnosis

The definition of IIH is based on the presence of raised intracranial pressure without an identifiable cause, normal cerebrospinal fluid composition, and the absence of hydrocephalus or mass lesion 1.

  • The diagnosis of IIH is often made in patients who are female, of childbearing age, and have a body mass index (BMI) greater than 30 kg/m2, which is referred to as typical IIH 1.
  • Atypical IIH refers to patients who do not fit this demographic profile and may require more in-depth investigation to rule out other underlying causes 1.

Symptoms and Management

Patients with IIH may experience symptoms such as headache, transient visual obscurations, pulsatile tinnitus, and visual blurring, among others 1.

  • The management of IIH focuses on treating the underlying disease, protecting vision, and minimizing headache morbidity 1.
  • Treatment may involve weight loss, medications to reduce intracranial pressure, and monitoring for complications such as vision loss 1.

Key Considerations

It is essential to note that IIH is a condition that requires prompt diagnosis and treatment to prevent long-term complications, such as vision loss and chronic headache 1.

  • Regular monitoring and follow-up with a healthcare provider are crucial to manage the condition effectively and prevent disease progression 1.

From the Research

Definition of IIAH

  • Idiopathic intracranial hypertension (IIH) is a neurological disorder characterized by increased intracranial pressure without any identifiable cause 2, 3, 4, 5, 6
  • It is also known as pseudotumor cerebri, and its symptoms include headache, nausea, vomiting, double vision, and papilledema (swelling of the optic disc) 2, 4

Diagnosis and Treatment

  • Diagnosis of IIH typically involves a lumbar puncture (LP) to measure the cerebrospinal fluid (CSF) pressure, as well as imaging studies such as MRI or CT scans to rule out other causes of increased intracranial pressure 2, 5
  • Treatment for IIH usually involves medications such as acetazolamide or topiramate to reduce CSF production and alleviate symptoms 2, 3
  • In some cases, surgical interventions such as CSF shunting or venous sinus stenting may be necessary to relieve increased intracranial pressure and prevent vision loss 6

Clinical Characteristics

  • IIH typically affects young, obese women, and its clinical characteristics include papilledema, headache, and visual disturbances 4, 5
  • The condition can be associated with venous hypertension, and the pressure gradient across the dominant venous sinus has been correlated with the lumbar puncture opening pressure 6

Management and Prognosis

  • Management of IIH involves a multidisciplinary approach, including medical treatment, lifestyle modifications, and surgical interventions when necessary 2, 3, 4, 5, 6
  • Prognosis for IIH is generally good, but prompt treatment is essential to prevent vision loss and other complications 2, 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Can Lumbar Puncture Be Safely Deferred in Patients With Mild Presumed Idiopathic Intracranial Hypertension?

Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society, 2022

Research

Correlation between lumbar puncture opening pressure and venous sinus pressure gradient in idiopathic intracranial hypertension (IIH).

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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