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class="vector-toc-text"> <span class="vector-toc-numb">5.3</span> <span>Venous sinus stenting</span> </div> </a> <ul id="toc-Venous_sinus_stenting-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Surgery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Surgery"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.4</span> <span>Surgery</span> </div> </a> <ul id="toc-Surgery-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Prognosis</span> </div> </a> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Epidemiology</span> </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>History</span> </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Idiopathic intracranial hypertension</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 22 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-22" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">22 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%81%D8%B1%D8%B7_%D8%A7%D9%84%D8%B6%D8%BA%D8%B7_%D8%AF%D8%A7%D8%AE%D9%84_%D8%A7%D9%84%D9%82%D8%AD%D9%81_%D9%85%D8%AC%D9%87%D9%88%D9%84_%D8%A7%D9%84%D8%B3%D8%A8%D8%A8" title="فرط الضغط داخل القحف مجهول السبب – Arabic" lang="ar" hreflang="ar" data-title="فرط الضغط داخل القحف مجهول السبب" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%A3%D0%BD%D1%83%D1%82%D1%80%D1%8B%D1%87%D0%B0%D1%80%D0%B0%D0%BF%D0%BD%D0%B0%D1%8F_%D0%B3%D1%96%D0%BF%D0%B5%D1%80%D1%82%D1%8D%D0%BD%D0%B7%D1%96%D1%8F" title="Унутрычарапная гіпертэнзія – Belarusian" lang="be" hreflang="be" data-title="Унутрычарапная гіпертэнзія" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target"><span>Беларуская</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Hipertensi%C3%B3_intracranial_idiop%C3%A0tica" title="Hipertensió intracranial idiopàtica – Catalan" lang="ca" hreflang="ca" data-title="Hipertensió intracranial idiopàtica" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Idiopathische_intrakranielle_Hypertension" title="Idiopathische intrakranielle Hypertension – German" lang="de" hreflang="de" data-title="Idiopathische intrakranielle Hypertension" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%99%CE%B4%CE%B9%CE%BF%CF%80%CE%B1%CE%B8%CE%AE%CF%82_%CE%B5%CE%BD%CE%B4%CE%BF%CE%BA%CF%81%CE%B1%CE%BD%CE%B9%CE%B1%CE%BA%CE%AE_%CF%85%CF%80%CE%AD%CF%81%CF%84%CE%B1%CF%83%CE%B7" title="Ιδιοπαθής ενδοκρανιακή υπέρταση – Greek" lang="el" hreflang="el" data-title="Ιδιοπαθής ενδοκρανιακή υπέρταση" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Pseudotumor_cerebral" title="Pseudotumor cerebral – Spanish" lang="es" hreflang="es" data-title="Pseudotumor cerebral" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Hypertension_intracr%C3%A2nienne_idiopathique" title="Hypertension intracrânienne idiopathique – French" lang="fr" hreflang="fr" data-title="Hypertension intracrânienne idiopathique" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%ED%8A%B9%EB%B0%9C%EC%84%B1_%EB%91%90%EA%B0%9C%EB%82%B4_%EA%B3%A0%ED%98%88%EC%95%95" title="특발성 두개내 고혈압 – Korean" lang="ko" hreflang="ko" data-title="특발성 두개내 고혈압" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Hipertensi_intrakranial_idiopatik" title="Hipertensi intrakranial idiopatik – Indonesian" lang="id" hreflang="id" data-title="Hipertensi intrakranial idiopatik" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Ipertensione_endocranica" title="Ipertensione endocranica – Italian" lang="it" hreflang="it" data-title="Ipertensione endocranica" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%99%D7%AA%D7%A8_%D7%9C%D7%97%D7%A5_%D7%AA%D7%95%D7%9A-%D7%92%D7%95%D7%9C%D7%92%D7%95%D7%9C%D7%AA%D7%99_%D7%A2%D7%A6%D7%9E%D7%95%D7%A0%D7%99" title="יתר לחץ תוך-גולגולתי עצמוני – Hebrew" lang="he" hreflang="he" data-title="יתר לחץ תוך-גולגולתי עצמוני" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Pseudotumor_cerebri" title="Pseudotumor cerebri – Dutch" lang="nl" hreflang="nl" data-title="Pseudotumor cerebri" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Idiopatisk_intrakranial_hypertensjon" title="Idiopatisk intrakranial hypertensjon – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Idiopatisk intrakranial hypertensjon" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%87%E0%AC%A1%E0%AC%BF%E0%AC%93%E0%AC%AA%E0%AC%BE%E0%AC%A5%E0%AC%BF%E0%AC%95_%E0%AC%87%E0%AC%A3%E0%AD%8D%E0%AC%9F%E0%AD%8D%E0%AC%B0%E0%AC%BE%E0%AC%95%E0%AD%8D%E0%AC%B0%E0%AC%BE%E0%AC%A8%E0%AC%BF%E0%AC%86%E0%AC%B2_%E0%AC%B9%E0%AC%BE%E0%AC%87%E0%AC%AA%E0%AC%B0%E0%AC%9F%E0%AD%87%E0%AC%A8%E0%AC%B8%E0%AC%A8" title="ଇଡିଓପାଥିକ ଇଣ୍ଟ୍ରାକ୍ରାନିଆଲ ହାଇପରଟେନସନ – Odia" lang="or" hreflang="or" data-title="ଇଡିଓପାଥିକ ଇଣ୍ଟ୍ରାକ୍ରାନିଆଲ ହାଇପରଟେନସନ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Idiopatyczne_nadci%C5%9Bnienie_%C5%9Br%C3%B3dczaszkowe" title="Idiopatyczne nadciśnienie śródczaszkowe – Polish" lang="pl" hreflang="pl" data-title="Idiopatyczne nadciśnienie śródczaszkowe" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Hipertens%C3%A3o_intracraniana_idiop%C3%A1tica" title="Hipertensão intracraniana idiopática – Portuguese" lang="pt" hreflang="pt" data-title="Hipertensão intracraniana idiopática" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Hipertensiune_intracranian%C4%83" title="Hipertensiune intracraniană – Romanian" lang="ro" hreflang="ro" data-title="Hipertensiune intracraniană" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%92%D0%BD%D1%83%D1%82%D1%80%D0%B8%D1%87%D0%B5%D1%80%D0%B5%D0%BF%D0%BD%D0%B0%D1%8F_%D0%B3%D0%B8%D0%BF%D0%B5%D1%80%D1%82%D0%B5%D0%BD%D0%B7%D0%B8%D1%8F" title="Внутричерепная гипертензия – Russian" lang="ru" hreflang="ru" data-title="Внутричерепная гипертензия" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Idiopatisk_intrakraniell_hypertension" title="Idiopatisk intrakraniell hypertension – Swedish" lang="sv" hreflang="sv" data-title="Idiopatisk intrakraniell hypertension" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tt mw-list-item"><a href="https://tt.wikipedia.org/wiki/%D0%91%D0%B0%D1%88_%D1%8D%D1%87%D0%B5%D0%BD%D0%B4%D3%99%D0%B3%D0%B5_%D0%B8%D0%B4%D0%B8%D0%BE%D0%BF%D0%B0%D1%82%D0%B8%D1%8F%D0%BB%D0%B5_%D0%B3%D0%B8%D0%BF%D0%B5%D1%80%D1%82%D0%B5%D0%BD%D0%B7%D0%B8%D1%8F" title="Баш эчендәге идиопатияле гипертензия – Tatar" lang="tt" hreflang="tt" data-title="Баш эчендәге идиопатияле гипертензия" data-language-autonym="Татарча / tatarça" data-language-local-name="Tatar" class="interlanguage-link-target"><span>Татарча / tatarça</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%92%D0%BD%D1%83%D1%82%D1%80%D1%96%D1%88%D0%BD%D1%8C%D0%BE%D1%87%D0%B5%D1%80%D0%B5%D0%BF%D0%BD%D0%B0_%D0%B3%D1%96%D0%BF%D0%B5%D1%80%D1%82%D0%B5%D0%BD%D0%B7%D1%96%D1%8F" title="Внутрішньочерепна гіпертензія – Ukrainian" lang="uk" hreflang="uk" data-title="Внутрішньочерепна гіпертензія" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-vi badge-Q17437798 badge-goodarticle mw-list-item" title="good article badge"><a href="https://vi.wikipedia.org/wiki/T%C4%83ng_%C3%A1p_l%E1%BB%B1c_n%E1%BB%99i_s%E1%BB%8D_v%C3%B4_c%C4%83n" title="Tăng áp lực nội sọ vô căn – Vietnamese" lang="vi" hreflang="vi" data-title="Tăng áp lực nội sọ vô căn" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q741208#sitelinks-wikipedia" title="Edit interlanguage links" class="wbc-editpage">Edit links</a></span></div> </div> </div> </div> </header> <div class="vector-page-toolbar"> <div 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Click here for more information." src="//upload.wikimedia.org/wikipedia/en/thumb/9/94/Symbol_support_vote.svg/19px-Symbol_support_vote.svg.png" decoding="async" width="19" height="20" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/94/Symbol_support_vote.svg/29px-Symbol_support_vote.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/94/Symbol_support_vote.svg/39px-Symbol_support_vote.svg.png 2x" data-file-width="180" data-file-height="185" /></a></span></div></div> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Idiopathic intracranial hypertension</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Benign intracranial hypertension (BIH),<sup id="cite_ref-Wal2017_1-0" class="reference"><a href="#cite_note-Wal2017-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> pseudotumor cerebri (PTC)<sup id="cite_ref-NEI2014_2-0" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:MRI_brain.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/3b/MRI_brain.jpg/220px-MRI_brain.jpg" decoding="async" width="220" height="234" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/3/3b/MRI_brain.jpg 1.5x" data-file-width="238" data-file-height="253" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">For the diagnosis, brain scans (such as MRI) should be done to rule out other potential causes.</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Neurology" title="Neurology">Neurology</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data"><a href="/wiki/Headache" title="Headache">Headache</a>, vision problems, <a href="/wiki/Tinnitus#Pulsatile_tinnitus" title="Tinnitus">ringing in the ears with the heartbeat</a><sup id="cite_ref-Wal2017_1-1" class="reference"><a href="#cite_note-Wal2017-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-NEI2014_2-1" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="infobox-data"><a href="/wiki/Vision_loss" class="mw-redirect" title="Vision loss">Vision loss</a><sup id="cite_ref-NEI2014_2-2" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Usual onset</th><td class="infobox-data">20–50 years old<sup id="cite_ref-NEI2014_2-3" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Risk_factor" title="Risk factor">Risk factors</a></th><td class="infobox-data">Hypervitaminosis A, obesity, <a href="/wiki/Tetracyclines" class="mw-redirect" title="Tetracyclines">tetracyclines</a><sup id="cite_ref-Wal2017_1-2" class="reference"><a href="#cite_note-Wal2017-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-NEI2014_2-4" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data">Based on symptoms, <a href="/wiki/Lumbar_puncture" title="Lumbar puncture">lumbar puncture</a>, <a href="/wiki/Brain_imaging" class="mw-redirect" title="Brain imaging">brain imaging</a><sup id="cite_ref-Wal2017_1-3" class="reference"><a href="#cite_note-Wal2017-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-NEI2014_2-5" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Differential_diagnosis" title="Differential diagnosis">Differential diagnosis</a></th><td class="infobox-data"><a href="/wiki/Brain_tumor" title="Brain tumor">Brain tumor</a>, <a href="/wiki/Arachnoiditis" title="Arachnoiditis">arachnoiditis</a>, <a href="/wiki/Meningitis" title="Meningitis">meningitis</a><sup id="cite_ref-NORD2015_3-0" class="reference"><a href="#cite_note-NORD2015-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data">Healthy diet, salt restriction, exercise, surgery<sup id="cite_ref-NEI2014_2-6" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medication" title="Medication">Medication</a></th><td class="infobox-data"><a href="/wiki/Acetazolamide" title="Acetazolamide">Acetazolamide</a><sup id="cite_ref-NEI2014_2-7" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Prognosis" title="Prognosis">Prognosis</a></th><td class="infobox-data">Variable<sup id="cite_ref-NEI2014_2-8" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">2 per 100,000 per year<sup id="cite_ref-Wak2015_4-0" class="reference"><a href="#cite_note-Wak2015-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr></tbody></table> <p><b>Idiopathic intracranial hypertension</b> (<b>IIH</b>), previously known as <b>pseudotumor cerebri</b> and <b>benign intracranial hypertension</b>, is a condition characterized by increased <a href="/wiki/Intracranial_pressure" title="Intracranial pressure">intracranial pressure</a> (pressure around the brain) without a detectable cause.<sup id="cite_ref-NEI2014_2-9" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The main symptoms are <a href="/wiki/Headache" title="Headache">headache</a>, vision problems, <a href="/wiki/Ringing_in_the_ears" class="mw-redirect" title="Ringing in the ears">ringing in the ears</a>, and shoulder pain.<sup id="cite_ref-Wal2017_1-4" class="reference"><a href="#cite_note-Wal2017-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-NEI2014_2-10" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Complications may include <a href="/wiki/Vision_loss" class="mw-redirect" title="Vision loss">vision loss</a>.<sup id="cite_ref-NEI2014_2-11" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>This condition is idiopathic, meaning there is no known cause. Risk factors include being overweight or a recent increase in weight.<sup id="cite_ref-Wal2017_1-5" class="reference"><a href="#cite_note-Wal2017-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Tetracycline" title="Tetracycline">Tetracycline</a> may also trigger the condition.<sup id="cite_ref-NEI2014_2-12" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The diagnosis is based on symptoms and a high opening pressure found during a <a href="/wiki/Lumbar_puncture" title="Lumbar puncture">lumbar puncture</a> with no specific cause found on a <a href="/wiki/Neuroimaging" title="Neuroimaging">brain scan</a>.<sup id="cite_ref-Wal2017_1-6" class="reference"><a href="#cite_note-Wal2017-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-NEI2014_2-13" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>Treatment includes a healthy diet, salt restriction, and exercise.<sup id="cite_ref-NEI2014_2-14" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The medication <a href="/wiki/Acetazolamide" title="Acetazolamide">acetazolamide</a> may also be used along with the above measures.<sup id="cite_ref-NEI2014_2-15" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> A small percentage of people may require surgery to relieve the pressure.<sup id="cite_ref-NEI2014_2-16" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>About 2 per 100,000 people are newly affected per year.<sup id="cite_ref-Wak2015_4-1" class="reference"><a href="#cite_note-Wak2015-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> The condition most commonly affects women aged 20–50.<sup id="cite_ref-NEI2014_2-17" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Women are affected about 20 times more often than men.<sup id="cite_ref-NEI2014_2-18" class="reference"><a href="#cite_note-NEI2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The condition was first described in 1897.<sup id="cite_ref-Wal2017_1-7" class="reference"><a href="#cite_note-Wal2017-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Idiopathic_intracranial_hypertension&action=edit&section=1" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The most common symptom of IIH is severe headache, which occurs in almost all (92–94%) cases. It is characteristically worse in the morning, generalized in character and throbbing in nature. It may be associated with nausea and vomiting. The headache can be made worse by <a href="/wiki/Valsalva_maneuver" title="Valsalva maneuver">any activity that further increases the intracranial pressure</a>, such as <a href="/wiki/Cough" title="Cough">coughing</a> and <a href="/wiki/Sneeze" title="Sneeze">sneezing</a>. The pain may also be experienced in the neck and shoulders.<sup id="cite_ref-Binder_5-0" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Many have <a href="/wiki/Tinnitus" title="Tinnitus">pulsatile tinnitus</a>, a whooshing sensation in one or both ears (64–87%); this sound is synchronous with the pulse.<sup id="cite_ref-Binder_5-1" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Various other symptoms, such as numbness of the extremities, generalized weakness, pain and/or numbness in one or both sides of the face, loss of smell, and <a href="/wiki/Ataxia" title="Ataxia">loss of coordination</a>, are reported more rarely; none are specific for IIH.<sup id="cite_ref-Binder_5-2" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> In children, numerous nonspecific signs and symptoms may be present.<sup id="cite_ref-Soler_7-0" class="reference"><a href="#cite_note-Soler-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>The increased pressure leads to compression and traction of the <a href="/wiki/Cranial_nerve" class="mw-redirect" title="Cranial nerve">cranial nerves</a>, a group of nerves that arise from the <a href="/wiki/Brain_stem" class="mw-redirect" title="Brain stem">brain stem</a> and supply the face and neck. Most commonly, the <a href="/wiki/Abducens_nerve" title="Abducens nerve">abducens nerve</a> (sixth nerve) is involved. This nerve supplies the muscle that pulls the eye outward. Those with <a href="/wiki/Sixth_nerve_palsy" title="Sixth nerve palsy">sixth nerve palsy</a> therefore experience horizontal double vision which is worse when looking towards the affected side. More rarely, the <a href="/wiki/Oculomotor_nerve" title="Oculomotor nerve">oculomotor nerve</a> and <a href="/wiki/Trochlear_nerve" title="Trochlear nerve">trochlear nerve</a> (<a href="/wiki/Oculomotor_nerve_palsy" title="Oculomotor nerve palsy">third</a> and <a href="/wiki/Fourth_nerve_palsy" title="Fourth nerve palsy">fourth nerve palsy</a>, respectively) are affected; both play a role in eye movements.<sup id="cite_ref-Soler_7-1" class="reference"><a href="#cite_note-Soler-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-FriedmanJacobson2002_8-0" class="reference"><a href="#cite_note-FriedmanJacobson2002-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Facial_nerve" title="Facial nerve">facial nerve</a> (seventh cranial nerve) is affected occasionally – the result is total or partial <a href="/wiki/Facial_nerve_paralysis" title="Facial nerve paralysis">weakness of the muscles of facial expression</a> on one or both sides of the face.<sup id="cite_ref-Binder_5-3" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>The increased pressure leads to <a href="/wiki/Papilledema" title="Papilledema">papilledema</a>, which is swelling of the <a href="/wiki/Optic_disc" title="Optic disc">optic disc</a>, the spot where the <a href="/wiki/Optic_nerve" title="Optic nerve">optic nerve</a> enters the <a href="/wiki/Human_eye" title="Human eye">eyeball</a>. This occurs in practically all cases of IIH, but not everyone experiences symptoms from this. Those who do experience symptoms typically report "transient visual obscurations", episodes of difficulty seeing that occur in both eyes but not necessarily at the same time. Long-term untreated papilledema leads to visual loss, initially in the periphery but progressively towards the center of vision.<sup id="cite_ref-Binder_5-4" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Acheson_9-0" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Neurological_examination" title="Neurological examination">Physical examination of the nervous system</a> is typically normal apart from the presence of papilledema, which is seen on examination of the eye with a small device called an <a href="/wiki/Ophthalmoscope" class="mw-redirect" title="Ophthalmoscope">ophthalmoscope</a> or in more detail with a <a href="/wiki/Fundus_camera" class="mw-redirect" title="Fundus camera">fundus camera</a>. If there are cranial nerve abnormalities, these may be noticed on <a href="/wiki/Eye_examination" title="Eye examination">eye examination</a> in the form of a <a href="/wiki/Strabismus" title="Strabismus">squint</a> (third, fourth, or sixth nerve palsy) or as facial nerve palsy. If the papilledema has been longstanding, <a href="/wiki/Visual_field" title="Visual field">visual fields</a> may be constricted and <a href="/wiki/Visual_acuity" title="Visual acuity">visual acuity</a> may be decreased. <a href="/wiki/Visual_field_test" title="Visual field test">Visual field testing</a> by automated (<a href="/wiki/Humphrey_visual_field_analyser" title="Humphrey visual field analyser">Humphrey</a>) perimetry is recommended as other methods of testing may be less accurate. Longstanding papilledema leads to <a href="/wiki/Optic_atrophy" class="mw-redirect" title="Optic atrophy">optic atrophy</a>, in which the disc looks pale and visual loss tends to be advanced.<sup id="cite_ref-Binder_5-5" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Acheson_9-1" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Causes">Causes</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Idiopathic_intracranial_hypertension&action=edit&section=2" title="Edit section: Causes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>"Idiopathic" means of unknown cause. Therefore, IIH can only be diagnosed if there is no alternative explanation for the symptoms. <a href="/wiki/Intracranial_pressure" title="Intracranial pressure">Intracranial pressure</a> may be increased due to medications such as high-dose <a href="/wiki/Vitamin_A" title="Vitamin A">vitamin A</a> derivatives (e.g., <a href="/wiki/Isotretinoin" title="Isotretinoin">isotretinoin</a> for <a href="/wiki/Acne_vulgaris" class="mw-redirect" title="Acne vulgaris">acne</a>),<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> long-term <a href="/wiki/Tetracycline_antibiotics" title="Tetracycline antibiotics">tetracycline antibiotics</a> (for a variety of skin conditions).<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Hormonal_contraceptives" class="mw-redirect" title="Hormonal contraceptives">Hormonal contraceptives</a>, particularly the oral contraceptive pill (OCP), are not associated with IIH.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> A systematic review published in 2020 suggests the use of the term "<a href="/wiki/Drug-induced_intracranial_hypertension_(DIIH)" class="mw-redirect" title="Drug-induced intracranial hypertension (DIIH)">drug-induced intracranial hypertension (DIIH)</a>" after having applied a 'strict drug-causality algorithm' in determining IIH cases likely caused by the drugs they evaluated.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p><p>There are numerous other diseases, mostly rare conditions, that may lead to intracranial hypertension. If there is an underlying cause, the condition is termed "secondary intracranial hypertension".<sup id="cite_ref-Binder_5-6" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Common causes of secondary intracranial hypertension include <a href="/wiki/Obstructive_sleep_apnea" title="Obstructive sleep apnea">obstructive sleep apnea</a> (a sleep-related breathing disorder), <a href="/wiki/Systemic_lupus_erythematosus" class="mw-redirect" title="Systemic lupus erythematosus">systemic lupus erythematosus</a> (SLE), <a href="/wiki/Chronic_kidney_disease" title="Chronic kidney disease">chronic kidney disease</a>, and <a href="/wiki/Beh%C3%A7et%27s_disease" title="Behçet's disease">Behçet's disease</a>.<sup id="cite_ref-Acheson_9-2" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>On July 1, 2022, the FDA issued an update that gonadotropin-releasing hormone agonists, drugs that are approved for treating precocious puberty, may be a risk factor for developing pseudotumor cerebri.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Mechanism">Mechanism</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Idiopathic_intracranial_hypertension&action=edit&section=3" title="Edit section: Mechanism"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The cause of IIH is not known. The <a href="/wiki/Monro%E2%80%93Kellie_rule" class="mw-redirect" title="Monro–Kellie rule">Monro–Kellie rule</a> states that the intracranial pressure is determined by the amount of brain tissue, <a href="/wiki/Cerebrospinal_fluid" title="Cerebrospinal fluid">cerebrospinal fluid</a> (CSF) and blood inside the bony cranial vault. Three theories therefore exist as to why the pressure might be raised in IIH: an excess of CSF production, increased volume of blood or brain tissue, or obstruction of the <a href="/wiki/Cerebral_veins" title="Cerebral veins">veins that drain blood from the brain</a>.<sup id="cite_ref-Binder_5-7" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>The first theory, that of increased production of cerebrospinal fluid, was proposed in early descriptions of the disease. However, there is no experimental data that supports a role for this process in IIH.<sup id="cite_ref-Binder_5-8" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>The second theory posits that either increased blood flow to the brain or increase in the brain tissue itself may result in the raised pressure. Little evidence has accumulated to support the suggestion that increased blood flow plays a role, but recently Bateman et al. in phase contrast MRA studies have quantified cerebral blood flow (CBF) in vivo and suggests that CBF is abnormally elevated in many people with IIH. Both <a href="/wiki/Biopsy" title="Biopsy">biopsy</a> samples and various types of brain scans have shown an increased water content of the brain tissue. It remains unclear why this might be the case.<sup id="cite_ref-Binder_5-9" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>The third theory suggests that restricted venous drainage from the brain may be impaired resulting in congestion. Many people with IIH have narrowing of the <a href="/wiki/Transverse_sinuses" title="Transverse sinuses">transverse sinuses</a>.<sup id="cite_ref-Farb_15-0" class="reference"><a href="#cite_note-Farb-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> It is not clear whether this narrowing is the pathogenesis of the disease or a secondary phenomenon. It has been proposed that a positive biofeedback loop may exist, where raised ICP (<a href="/wiki/Intracranial_pressure" title="Intracranial pressure">intracranial pressure</a>) causes venous narrowing in the <a href="/wiki/Transverse_sinuses" title="Transverse sinuses">transverse sinuses</a>, resulting in venous hypertension (raised venous pressure), decreased CSF resorption via <a href="/wiki/Arachnoid_granulation" title="Arachnoid granulation">arachnoid granulation</a> and further rise in ICP.<sup id="cite_ref-Ahmed_16-0" class="reference"><a href="#cite_note-Ahmed-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Idiopathic_intracranial_hypertension&action=edit&section=4" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:UOTW_5_-_Ultrasound_of_the_Week_2_(cropped).jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/83/UOTW_5_-_Ultrasound_of_the_Week_2_%28cropped%29.jpg/290px-UOTW_5_-_Ultrasound_of_the_Week_2_%28cropped%29.jpg" decoding="async" width="290" height="190" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/83/UOTW_5_-_Ultrasound_of_the_Week_2_%28cropped%29.jpg/435px-UOTW_5_-_Ultrasound_of_the_Week_2_%28cropped%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/8/83/UOTW_5_-_Ultrasound_of_the_Week_2_%28cropped%29.jpg 2x" data-file-width="549" data-file-height="359" /></a><figcaption>Ultrasound of the optic nerve showing IIH<sup id="cite_ref-UOTW5_17-0" class="reference"><a href="#cite_note-UOTW5-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup></figcaption></figure> <p>The diagnosis may be suspected on the basis of the history and examination. To confirm the diagnosis, as well as excluding alternative causes, several investigations are required; more investigations may be performed if the history is not typical or the person is more likely to have an alternative problem: children, men, the elderly, or women who are not overweight.<sup id="cite_ref-FriedmanJacobson2002_8-1" class="reference"><a href="#cite_note-FriedmanJacobson2002-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Investigations">Investigations</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Idiopathic_intracranial_hypertension&action=edit&section=5" title="Edit section: Investigations"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Neuroimaging" title="Neuroimaging">Neuroimaging</a>, usually with <a href="/wiki/Computed_tomography" class="mw-redirect" title="Computed tomography">computed tomography</a> (CT/CAT) or <a href="/wiki/Magnetic_resonance_imaging" title="Magnetic resonance imaging">magnetic resonance imaging</a> (MRI), is used to exclude any mass lesions. In IIH these scans typically appear to be normal, although small or slit-like <a href="/wiki/Ventricular_system" title="Ventricular system">ventricles</a>, dilatation and buckling<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> of the optic nerve sheaths and "<a href="/wiki/Empty_sella_syndrome" title="Empty sella syndrome">empty sella sign</a>" (flattening of the <a href="/wiki/Pituitary_gland" title="Pituitary gland">pituitary gland</a> due to increased pressure) and enlargement of Meckel's caves may be seen. </p><p>An MR venogram is also performed in most cases to exclude the possibility of venous sinus stenosis/obstruction or <a href="/wiki/Cerebral_venous_sinus_thrombosis" title="Cerebral venous sinus thrombosis">cerebral venous sinus thrombosis</a>.<sup id="cite_ref-Binder_5-10" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Soler_7-2" class="reference"><a href="#cite_note-Soler-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-FriedmanJacobson2002_8-2" class="reference"><a href="#cite_note-FriedmanJacobson2002-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> A contrast-enhanced MRV (ATECO) scan has a high detection rate for abnormal transverse sinus stenoses.<sup id="cite_ref-Farb_15-1" class="reference"><a href="#cite_note-Farb-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> These stenoses can be more adequately identified and assessed with catheter cerebral venography and manometry.<sup id="cite_ref-Ahmed_16-1" class="reference"><a href="#cite_note-Ahmed-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> Buckling of the bilateral optic nerves with increased perineural fluid is also often noted on MRI imaging. </p><p><a href="/wiki/Lumbar_puncture" title="Lumbar puncture">Lumbar puncture</a> is performed to measure the opening pressure, as well as to obtain <a href="/wiki/Cerebrospinal_fluid" title="Cerebrospinal fluid">cerebrospinal fluid</a> (CSF) to exclude alternative diagnoses. If the opening pressure is increased, CSF may be removed for transient relief (see below).<sup id="cite_ref-FriedmanJacobson2002_8-3" class="reference"><a href="#cite_note-FriedmanJacobson2002-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> The CSF is examined for abnormal cells, infections, antibody levels, the <a href="/wiki/Glucose" title="Glucose">glucose</a> level, and <a href="/wiki/Protein" title="Protein">protein</a> levels. By definition, all of these are within their normal limits in IIH.<sup id="cite_ref-FriedmanJacobson2002_8-4" class="reference"><a href="#cite_note-FriedmanJacobson2002-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> Occasionally, the CSF pressure measurement may be normal despite very suggestive symptoms. This may be attributable to the fact that CSF pressure may fluctuate over the course of the normal day. If the suspicion of problems remains high, it may be necessary to perform more long-term monitoring of the ICP by a pressure catheter.<sup id="cite_ref-FriedmanJacobson2002_8-5" class="reference"><a href="#cite_note-FriedmanJacobson2002-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Classification">Classification</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Idiopathic_intracranial_hypertension&action=edit&section=6" title="Edit section: Classification"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The original criteria for IIH were described by <a href="/wiki/Walter_Dandy" title="Walter Dandy">Dandy</a> in 1937.<sup id="cite_ref-Dandy1937_19-0" class="reference"><a href="#cite_note-Dandy1937-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p> <table border="1" align="center" style="text-align: center; background: #FFFFFF;"> <caption>Dandy criteria<sup id="cite_ref-Dandy1937_19-1" class="reference"><a href="#cite_note-Dandy1937-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </caption> <tbody><tr bgcolor="#EFEFEF"> <td>1 Signs & symptoms of increased ICP – CSF pressure >25 cmH<sub>2</sub>O </td></tr> <tr bgcolor="#EFEFEF"> <td>2 No localizing signs with the exception of abducens nerve palsy </td></tr> <tr bgcolor="#EFEFEF"> <td>3 Normal CSF composition </td></tr> <tr bgcolor="#EFEFEF"> <td>4 Normal to small (slit) ventricles on imaging with no intracranial mass </td></tr></tbody></table> <p>They were modified by Smith in 1985 to become the "modified Dandy criteria". Smith included the use of more advanced imaging: Dandy had required <a href="/wiki/Cerebral_ventriculography" class="mw-redirect" title="Cerebral ventriculography">ventriculography</a>, but Smith replaced this with <a href="/wiki/Computed_tomography" class="mw-redirect" title="Computed tomography">computed tomography</a>.<sup id="cite_ref-JLSmith_20-0" class="reference"><a href="#cite_note-JLSmith-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> In a 2001 paper, Digre and Corbett amended Dandy's criteria further. They added the requirement that the person is awake and alert, as coma precludes adequate neurological assessment, and require exclusion of venous sinus thrombosis as an underlying cause. Furthermore, they added the requirement that no other cause for the raised ICP is found.<sup id="cite_ref-Binder_5-11" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Acheson_9-3" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-DigreCorbett_21-0" class="reference"><a href="#cite_note-DigreCorbett-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> </p> <table border="1" align="center" style="text-align: center; background: #FFFFFF;"> <caption>Modified Dandy criteria<sup id="cite_ref-DigreCorbett_21-1" class="reference"><a href="#cite_note-DigreCorbett-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> </caption> <tbody><tr bgcolor="#EFEFEF"> <td>1 Symptoms of raised intracranial pressure (headache, nausea, vomiting, transient visual obscurations, or papilledema) </td></tr> <tr bgcolor="#EFEFEF"> <td>2 No localizing signs with the exception of abducens (sixth) nerve palsy </td></tr> <tr bgcolor="#EFEFEF"> <td>3 The patient is awake and alert </td></tr> <tr bgcolor="#EFEFEF"> <td>4 Normal CT/MRI findings without evidence of thrombosis </td></tr> <tr bgcolor="#EFEFEF"> <td>5 LP opening pressure of >25 cmH<sub>2</sub>O and normal biochemical and cytological composition of CSF </td></tr> <tr bgcolor="#EFEFEF"> <td>6 No other explanation for the raised intracranial pressure </td></tr></tbody></table> <p>In a 2002 review, Friedman and Jacobson propose an alternative set of criteria, derived from Smith's. These require the absence of symptoms that could not be explained by a diagnosis of IIH, but do not require the actual presence of any symptoms (such as headache) attributable to IIH. These criteria also require that the lumbar puncture is performed with the person lying sideways, as a lumbar puncture performed in the upright sitting position can lead to artificially high pressure measurements. Friedman and Jacobson also do not insist on MR venography for every person; rather, this is only required in atypical cases (see "diagnosis" above).<sup id="cite_ref-FriedmanJacobson2002_8-6" class="reference"><a href="#cite_note-FriedmanJacobson2002-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Idiopathic_intracranial_hypertension&action=edit&section=7" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The primary goal in treatment of IIH is the prevention of visual loss and blindness, as well as symptom control.<sup id="cite_ref-Acheson_9-4" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> IIH is treated mainly through the reduction of CSF pressure and IIH may resolve after initial treatment, may go into spontaneous remission (although it can still relapse at a later stage), or may continue chronically.<sup id="cite_ref-Binder_5-12" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-FriedmanJacobson2002_8-7" class="reference"><a href="#cite_note-FriedmanJacobson2002-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> There are three main treatment approaches: weight loss, different medications and surgical interventions. Remission is seen for most patients that achieve a weight loss of around 6–10%. Bariatric surgery can be an option for those patients that don't achieve weight loss with lifestyle changes and diet.<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Lumbar_puncture">Lumbar puncture</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Idiopathic_intracranial_hypertension&action=edit&section=8" title="Edit section: Lumbar puncture"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Wikipedian_getting_a_lumbar_puncture_(2006).jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/fe/Wikipedian_getting_a_lumbar_puncture_%282006%29.jpg/290px-Wikipedian_getting_a_lumbar_puncture_%282006%29.jpg" decoding="async" width="290" height="218" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/fe/Wikipedian_getting_a_lumbar_puncture_%282006%29.jpg/435px-Wikipedian_getting_a_lumbar_puncture_%282006%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/fe/Wikipedian_getting_a_lumbar_puncture_%282006%29.jpg/580px-Wikipedian_getting_a_lumbar_puncture_%282006%29.jpg 2x" data-file-width="2272" data-file-height="1704" /></a><figcaption>A <a href="/wiki/Lumbar_puncture" title="Lumbar puncture">lumbar puncture</a> in progress. A large area on the back has been washed with an <a href="/wiki/Iodine" title="Iodine">iodine</a>-based disinfectant leaving brown colouration. In this image the person is seated upright, which can make the procedure easier to perform but makes any measurement of the opening pressure unreliable.</figcaption></figure> <p>The first step in symptom control is drainage of cerebrospinal fluid by lumbar puncture. If necessary, this may be performed at the same time as a diagnostic LP (such as done in search of a CSF infection). In some cases, this is sufficient to control the symptoms, and no further treatment is needed.<sup id="cite_ref-Soler_7-3" class="reference"><a href="#cite_note-Soler-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Acheson_9-5" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>The procedure can be repeated if necessary, but this is generally taken as a clue that additional treatments may be required to control the symptoms and preserve vision. Repeated lumbar punctures are regarded as unpleasant by people, and they present a danger of introducing spinal infections if done too often.<sup id="cite_ref-Binder_5-13" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Soler_7-4" class="reference"><a href="#cite_note-Soler-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> Repeated lumbar punctures are sometimes needed to control the ICP urgently if the person's vision deteriorates rapidly.<sup id="cite_ref-Acheson_9-6" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Medication">Medication</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Idiopathic_intracranial_hypertension&action=edit&section=9" title="Edit section: Medication"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The best-studied medical treatment for intracranial hypertension is <a href="/wiki/Acetazolamide" title="Acetazolamide">acetazolamide</a> (Diamox), which acts by inhibiting the enzyme <a href="/wiki/Carbonic_anhydrase" title="Carbonic anhydrase">carbonic anhydrase</a>, and it reduces CSF production by six to 57 percent. It can cause the symptoms of <a href="/wiki/Hypokalemia" title="Hypokalemia">hypokalemia</a> (low blood potassium levels), which include muscle weakness and tingling in the fingers. Acetazolamide cannot be used in pregnancy, since it has been shown to cause embryonic abnormalities in animal studies. Also, in human beings it has been shown to cause <a href="/wiki/Metabolic_acidosis" title="Metabolic acidosis">metabolic acidosis</a> as well as <a href="/wiki/Water-electrolyte_imbalance" class="mw-redirect" title="Water-electrolyte imbalance">disruptions in the blood electrolyte levels</a> of newborn babies. The diuretic <a href="/wiki/Furosemide" title="Furosemide">furosemide</a> is sometimes used for a treatment if acetazolamide is not tolerated, but this drug sometimes has little effect on the ICP.<sup id="cite_ref-Binder_5-14" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Acheson_9-7" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>Various <a href="/wiki/Analgesic" title="Analgesic">analgesics</a> (painkillers) may be used in controlling the headaches of intracranial hypertension. In addition to conventional agents such as <a href="/wiki/Paracetamol" title="Paracetamol">paracetamol</a>, a low dose of the antidepressant <a href="/wiki/Amitriptyline" title="Amitriptyline">amitriptyline</a> or the anticonvulsant <a href="/wiki/Topiramate" title="Topiramate">topiramate</a> have shown some additional benefit for pain relief.<sup id="cite_ref-Acheson_9-8" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>The use of <a href="/wiki/Glucocorticoid" title="Glucocorticoid">steroids</a> in the attempt to reduce the ICP is controversial. These may be used in severe papilledema, but otherwise their use is discouraged.<sup id="cite_ref-Binder_5-15" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Venous_sinus_stenting">Venous sinus stenting</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Idiopathic_intracranial_hypertension&action=edit&section=10" title="Edit section: Venous sinus stenting"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Venous sinus stenoses leading to venous hypertension appear to play a significant part in relation to raised <a href="/wiki/Intracranial_pressure" title="Intracranial pressure">ICP</a>, and stenting of a <a href="/wiki/Transverse_sinus" class="mw-redirect" title="Transverse sinus">transverse sinus</a> may resolve venous hypertension, leading to improved <a href="/wiki/Cerebrospinal_fluid" title="Cerebrospinal fluid">CSF</a> resorption, decreased ICP, cure of papilledema and other symptoms of IIH.<sup id="cite_ref-Ahmed_16-2" class="reference"><a href="#cite_note-Ahmed-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p><p>A self-expanding metal stent is permanently deployed within the dominant <a href="/wiki/Transverse_sinus" class="mw-redirect" title="Transverse sinus">transverse sinus</a> across the stenosis under general anaesthesia. In general, people are discharged the next day. People require double antiplatelet therapy for a period of up to 3 months after the procedure and aspirin therapy for up to 1 year. </p><p>In a systematic analysis of 19 studies with 207 cases, there was an 87% improvement in overall symptom rate and 90% cure rate for treatment of papilledema. Major complications only occurred in 3/207 people (1.4%).<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> In the largest single series of transverse sinus stenting there was an 11% rate of recurrence after one stent, requiring further stenting.<sup id="cite_ref-Ahmed_16-3" class="reference"><a href="#cite_note-Ahmed-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p><p>Due to the permanence of the stent and small but definite risk of complications, most experts will recommend that person with IIH must have papilledema and have failed medical therapy or are intolerant to medication before stenting is undertaken. </p> <div class="mw-heading mw-heading3"><h3 id="Surgery">Surgery</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Idiopathic_intracranial_hypertension&action=edit&section=11" title="Edit section: Surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Two main surgical procedures are used for the treatment of IIH: <i>optic nerve sheath decompression and fenestration</i> and <a href="/wiki/Cerebral_shunt" title="Cerebral shunt">cerebral shunting</a>. Surgery would normally only be offered if medical therapy is either unsuccessful or not tolerated.<sup id="cite_ref-Soler_7-5" class="reference"><a href="#cite_note-Soler-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Acheson_9-9" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The choice between these two procedures depends on the predominant problem in IIH. Neither procedure is perfect: both may cause significant complications, and both may eventually fail in controlling the symptoms. There are no <a href="/wiki/Randomized_controlled_trial" title="Randomized controlled trial">randomized controlled trials</a> to guide the decision as to which procedure is best.<sup id="cite_ref-Acheson_9-10" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p><a href="/w/index.php?title=Optic_nerve_sheath_fenestration&action=edit&redlink=1" class="new" title="Optic nerve sheath fenestration (page does not exist)">Optic nerve sheath fenestration</a> is an operation that involves the making of an incision in the connective tissue lining of the <a href="/wiki/Optic_nerve" title="Optic nerve">optic nerve</a> in its portion behind the eye. It is not entirely clear how it protects the eye from the raised pressure, but it may be the result of either diversion of the CSF into the <a href="/wiki/Orbit_(anatomy)" title="Orbit (anatomy)">orbit</a> or the creation of an area of scar tissue that lowers the pressure.<sup id="cite_ref-Acheson_9-11" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The effects on the intracranial pressure itself are more modest. Moreover, the procedure may lead to significant complications, including blindness in 1–2%.<sup id="cite_ref-Binder_5-16" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> The procedure is therefore recommended mainly in those who have limited headache symptoms but significant papilledema or threatened vision, and those who have undergone unsuccessful treatment with a shunt or have a contraindication for shunt surgery.<sup id="cite_ref-Acheson_9-12" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>Shunt surgery, usually performed by <a href="/wiki/Neurosurgery" title="Neurosurgery">neurosurgeons</a>, involves the creation of a conduit by which CSF can be drained into another body cavity. The initial procedure is usually a <a href="/wiki/Lumbar-peritoneal_shunt" class="mw-redirect" title="Lumbar-peritoneal shunt">lumboperitoneal (LP) shunt</a>, which connects the subarachnoid space in the <a href="/wiki/Lumbar_spine" class="mw-redirect" title="Lumbar spine">lumbar spine</a> with the <a href="/wiki/Peritoneal_cavity" title="Peritoneal cavity">peritoneal cavity</a>.<sup id="cite_ref-pmid20508332_24-0" class="reference"><a href="#cite_note-pmid20508332-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> A pressure valve is usually included in the circuit to avoid excessive drainage when the person is erect. LP shunting provides long-term relief in about half the cases; others require revision of the shunt, often on more than one occasion, usually due to shunt obstruction. If the lumboperitoneal shunt needs repeated revisions, a <i>ventriculoatrial</i> or <i>ventriculoperitoneal shunt</i> may be considered. These shunts are inserted in one of the <a href="/wiki/Lateral_ventricles" title="Lateral ventricles">lateral ventricles</a> of the brain, usually by <a href="/wiki/Stereotactic_surgery" title="Stereotactic surgery">stereotactic surgery</a>, and then connected either to the <a href="/wiki/Right_atrium" class="mw-redirect" title="Right atrium">right atrium</a> of the heart or the peritoneal cavity.<sup id="cite_ref-Binder_5-17" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Acheson_9-13" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> Given the reduced need for revisions in ventricular shunts, it is possible that this procedure will become<sup class="noprint Inline-Template" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items" title="Wikipedia:Manual of Style/Dates and numbers"><span title="source cited is 2004 (December 2023)">when?</span></a></i>]</sup> the first-line type of shunt treatment.<sup id="cite_ref-Binder_5-18" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>It has been shown that in obese people, <a href="/wiki/Bariatric_surgery" title="Bariatric surgery">bariatric surgery</a> (and especially <a href="/wiki/Gastric_bypass_surgery" title="Gastric bypass surgery">gastric bypass surgery</a>) can lead to resolution of the condition in over 95%.<sup id="cite_ref-Binder_5-19" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Idiopathic_intracranial_hypertension&action=edit&section=12" title="Edit section: Prognosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>It is not known what percentage of people with IIH will remit spontaneously, and what percentage will develop chronic disease.<sup id="cite_ref-Acheson_9-14" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>IIH does not normally affect life expectancy. The major complications from IIH arise from untreated or treatment-resistant <a href="/wiki/Papilledema" title="Papilledema">papilledema</a>. In various case series, the long-term risk of one's vision being significantly affected by IIH is reported to lie anywhere between 10 and 25%.<sup id="cite_ref-Binder_5-20" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Acheson_9-15" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Idiopathic_intracranial_hypertension&action=edit&section=13" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:IIH_incidence.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/5f/IIH_incidence.png/290px-IIH_incidence.png" decoding="async" width="290" height="265" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/5f/IIH_incidence.png/435px-IIH_incidence.png 1.5x, //upload.wikimedia.org/wikipedia/commons/5/5f/IIH_incidence.png 2x" data-file-width="564" data-file-height="516" /></a><figcaption>The number of new cases per year of IIH is strongly determined by sex and <a href="/wiki/Body_weight" class="mw-redirect" title="Body weight">body weight</a>. The figures in females are in women between 20 and 45 years old.<sup id="cite_ref-Binder_5-21" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></figcaption></figure> <p>On average, IIH occurs in about one per 100,000 people, and can occur in children and adults. The <a href="/wiki/Median" title="Median">median</a> age at diagnosis is 30. IIH occurs predominantly in women, especially in the ages 20 to 45, who are four to eight times more likely than men to be affected. <a href="/wiki/Overweight" title="Overweight">Overweight</a> and <a href="/wiki/Obesity" title="Obesity">obesity</a> strongly predispose a person to IIH: women who are more than ten percent over their <a href="/wiki/Ideal_body_weight" class="mw-redirect" title="Ideal body weight">ideal body weight</a> are thirteen times more likely to develop IIH, and this figure goes up to nineteen times in women who are more than twenty percent over their ideal body weight. In men this relationship also exists, but the increase is only five-fold in those over 20 percent above their ideal body weight.<sup id="cite_ref-Binder_5-22" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>Despite several reports of IIH in families, there is no known genetic cause for IIH. People from all <a href="/wiki/Ethnicity" title="Ethnicity">ethnicities</a> may develop IIH.<sup id="cite_ref-Binder_5-23" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> In children, there is no difference in incidence between males and females.<sup id="cite_ref-Soler_7-6" class="reference"><a href="#cite_note-Soler-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>From national hospital admission databases it appears that the need for <a href="/wiki/Neurosurgical" class="mw-redirect" title="Neurosurgical">neurosurgical</a> intervention for IIH has increased markedly over the period between 1988 and 2002. This has been attributed at least in part to the rising prevalence of obesity,<sup id="cite_ref-Curry_et_al_2005_25-0" class="reference"><a href="#cite_note-Curry_et_al_2005-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> although some of this increase may be explained by the increased popularity of <a href="/wiki/Cerebral_shunt" title="Cerebral shunt">shunting</a> over optic nerve sheath fenestration.<sup id="cite_ref-Acheson_9-16" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Idiopathic_intracranial_hypertension&action=edit&section=14" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The first report of IIH was by the German physician <a href="/wiki/Heinrich_Quincke" title="Heinrich Quincke">Heinrich Quincke</a>, who described it in 1893 under the name <a href="/wiki/Serous_meningitis" class="mw-redirect" title="Serous meningitis">serous meningitis</a>.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> The term "pseudotumor cerebri" was introduced in 1904 by his compatriot <a href="/wiki/Max_Nonne" title="Max Nonne">Max Nonne</a>.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> Numerous other cases appeared in the literature subsequently; in many cases, the raised intracranial pressure may actually have resulted from underlying conditions.<sup id="cite_ref-Johnston_28-0" class="reference"><a href="#cite_note-Johnston-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> For instance, the <a href="/wiki/Otitic_hydrocephalus" class="mw-redirect" title="Otitic hydrocephalus">otitic hydrocephalus</a> reported by London neurologist Sir <a href="/wiki/Charles_Symonds" title="Charles Symonds">Charles Symonds</a> may have resulted from venous sinus thrombosis caused by <a href="/wiki/Otitis_media" title="Otitis media">middle ear infection</a>.<sup id="cite_ref-Johnston_28-1" class="reference"><a href="#cite_note-Johnston-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> Diagnostic criteria for IIH were developed in 1937 by the <a href="/wiki/Baltimore,_Maryland" class="mw-redirect" title="Baltimore, Maryland">Baltimore</a> neurosurgeon <a href="/wiki/Walter_Dandy" title="Walter Dandy">Walter Dandy</a>; Dandy also introduced subtemporal decompressive surgery in the treatment of the condition.<sup id="cite_ref-Dandy1937_19-2" class="reference"><a href="#cite_note-Dandy1937-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Johnston_28-2" class="reference"><a href="#cite_note-Johnston-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> </p><p>The terms "benign" and "pseudotumor" derive from the fact that increased intracranial pressure may be associated with <a href="/wiki/Brain_tumor" title="Brain tumor">brain tumors</a>. Those people in whom no tumour was found were therefore diagnosed with "pseudotumor cerebri" (a disease mimicking a brain tumor). The disease was renamed <a href="/wiki/Benign_intracranial_hypertension" class="mw-redirect" title="Benign intracranial hypertension">benign intracranial hypertension</a> in 1955 to distinguish it from intracranial hypertension due to life-threatening diseases (such as cancer);<sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> however, this was also felt to be misleading because any disease that can blind someone should not be thought of as benign, and the name was therefore revised in 1989 to "idiopathic (of no identifiable cause) intracranial hypertension".<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </p><p>Shunt surgery was introduced in 1949; initially, ventriculoperitoneal shunts were used. In 1971, good results were reported with lumboperitoneal shunting. Negative reports on shunting in the 1980s led to a brief period (1988–1993) during which optic nerve fenestration (which had initially been described in an unrelated condition in 1871) was more popular. Since then, shunting is recommended predominantly, with occasional exceptions.<sup id="cite_ref-Binder_5-24" class="reference"><a href="#cite_note-Binder-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Acheson_9-17" class="reference"><a href="#cite_note-Acheson-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Idiopathic_intracranial_hypertension&action=edit&section=15" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-Wal2017-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-Wal2017_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Wal2017_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Wal2017_1-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Wal2017_1-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-Wal2017_1-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-Wal2017_1-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-Wal2017_1-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-Wal2017_1-7"><sup><i><b>h</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output 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"Pseudotumor cerebri". <i>Archives of Neurology</i>. <b>58</b> (10): 1699–701. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Farchneur.58.10.1699">10.1001/archneur.58.10.1699</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11594936">11594936</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Archives+of+Neurology&rft.atitle=Pseudotumor+cerebri&rft.volume=58&rft.issue=10&rft.pages=1699-701&rft.date=2001&rft_id=info%3Adoi%2F10.1001%2Farchneur.58.10.1699&rft_id=info%3Apmid%2F11594936&rft.au=Bandyopadhyay+S&rfr_id=info%3Asid%2Fen.wikipedia.org%3AIdiopathic+intracranial+hypertension" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 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href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q741208" class="extiw" title="d:Q741208">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-11" title="ICD-11">11</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#925785183%2Fother">8D60.Y</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/G93.2">G93.2</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=348.2">348.2</a></li><li><b><a href="/wiki/Online_Mendelian_Inheritance_in_Man" title="Online Mendelian Inheritance in Man">OMIM</a></b>: <a rel="nofollow" class="external text" href="https://omim.org/entry/243200">243200</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D011559">D011559</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb1331.htm">1331</a></li><li><b><a href="/wiki/SNOMED_CT" title="SNOMED CT">SNOMED CT</a></b>: <a rel="nofollow" class="external text" href="http://snomed.info/id/68267002">68267002</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></b>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000351.htm">000351</a></li><li><b><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></b>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/neuro/329-overview">neuro/329</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/oph/topic190.htm#">oph/190</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/neuro/topic537.htm#">neuro/537</a></li><li><b><a href="/wiki/Patient_UK" title="Patient UK">Patient UK</a></b>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/idiopathic-intracranial-hypertension-pro">Idiopathic intracranial hypertension</a></li><li><b><a href="/wiki/Orphanet" title="Orphanet">Orphanet</a></b>: <a rel="nofollow" class="external text" href="https://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=en&Expert=238624">238624</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Diseases_of_the_nervous_system,_primarily_CNS" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Central_nervous_system_disease" title="Template:Central nervous system disease"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Central_nervous_system_disease" title="Template talk:Central nervous system disease"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Central_nervous_system_disease" title="Special:EditPage/Template:Central nervous system disease"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Diseases_of_the_nervous_system,_primarily_CNS" style="font-size:114%;margin:0 4em">Diseases of the <a href="/wiki/Nervous_system" title="Nervous system">nervous system</a>, primarily <a href="/wiki/Central_nervous_system_disease" title="Central nervous system disease">CNS</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Inflammation" title="Inflammation">Inflammation</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Brain" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_brain" title="Human brain">Brain</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Encephalitis" title="Encephalitis">Encephalitis</a> <ul><li><a href="/wiki/Viral_encephalitis" title="Viral encephalitis">Viral encephalitis</a></li> <li><a href="/wiki/Herpesviral_encephalitis" class="mw-redirect" title="Herpesviral encephalitis">Herpesviral encephalitis</a></li> <li><a href="/wiki/Limbic_encephalitis" title="Limbic encephalitis">Limbic encephalitis</a></li> <li><a href="/wiki/Encephalitis_lethargica" title="Encephalitis lethargica">Encephalitis lethargica</a></li></ul></li> <li><a href="/wiki/Cavernous_sinus_thrombosis" title="Cavernous sinus thrombosis">Cavernous sinus thrombosis</a></li> <li><a href="/wiki/Brain_abscess" title="Brain abscess">Brain abscess</a> <ul><li><a href="/wiki/Amoebic_brain_abscess" title="Amoebic brain abscess">Amoebic</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Brain and <a href="/wiki/Spinal_cord" title="Spinal cord">spinal cord</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Encephalomyelitis" title="Encephalomyelitis">Encephalomyelitis</a> <ul><li><a href="/wiki/Acute_disseminated_encephalomyelitis" title="Acute disseminated encephalomyelitis">Acute disseminated</a></li></ul></li> <li><a href="/wiki/Meningitis" title="Meningitis">Meningitis</a></li> <li><a href="/wiki/Meningoencephalitis" title="Meningoencephalitis">Meningoencephalitis</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_brain" title="Human brain">Brain</a>/<br /><a href="/wiki/Encephalopathy" title="Encephalopathy">encephalopathy</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Neurodegenerative_disease" title="Neurodegenerative disease">Degenerative</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Extrapyramidal_system" title="Extrapyramidal system">Extrapyramidal</a> and<br /><a href="/wiki/Movement_disorders" class="mw-redirect" title="Movement disorders">movement disorders</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Basal_ganglia_disease" title="Basal ganglia disease">Basal ganglia disease</a> <ul><li><a href="/wiki/Parkinsonism" title="Parkinsonism">Parkinsonism</a> <ul><li><a href="/wiki/Parkinson%27s_disease" title="Parkinson's disease">PD</a></li> <li><a href="/wiki/Postencephalitic_parkinsonism" class="mw-redirect" title="Postencephalitic parkinsonism">Postencephalitic</a></li> <li><a href="/wiki/Neuroleptic_malignant_syndrome" title="Neuroleptic malignant syndrome">NMS</a></li></ul></li> <li><a href="/wiki/Neurodegeneration_with_brain_iron_accumulation" title="Neurodegeneration with brain iron accumulation">NBIA</a> <ul><li><a href="/wiki/Pantothenate_kinase-associated_neurodegeneration" title="Pantothenate kinase-associated neurodegeneration">PKAN</a></li></ul></li> <li><a href="/wiki/Tauopathy" title="Tauopathy">Tauopathy</a> <ul><li><a href="/wiki/Progressive_supranuclear_palsy" title="Progressive supranuclear palsy">PSP</a></li></ul></li> <li><a href="/wiki/Multiple_system_atrophy" title="Multiple system atrophy">Striatonigral degeneration</a></li> <li><a href="/wiki/Hemiballismus" title="Hemiballismus">Hemiballismus</a></li> <li><a href="/wiki/Huntington%27s_disease" title="Huntington's disease">HD</a></li> <li><a href="/wiki/Olivopontocerebellar_atrophy" class="mw-redirect" title="Olivopontocerebellar atrophy">OA</a></li></ul></li></ul> <ul><li><a href="/wiki/Dyskinesia" title="Dyskinesia">Dyskinesia</a> <ul><li><a href="/wiki/Dystonia" title="Dystonia">Dystonia</a> <ul><li><a href="/wiki/Status_dystonicus" title="Status dystonicus">Status dystonicus</a></li> <li><a href="/wiki/Spasmodic_torticollis" title="Spasmodic torticollis">Spasmodic torticollis</a></li> <li><a href="/wiki/Meige%27s_syndrome" title="Meige's syndrome">Meige's</a></li> <li><a href="/wiki/Blepharospasm" title="Blepharospasm">Blepharospasm</a></li></ul></li> <li><a href="/wiki/Athetosis" title="Athetosis">Athetosis</a></li> <li><a href="/wiki/Chorea" title="Chorea">Chorea</a> <ul><li><a href="/wiki/Choreoathetosis" title="Choreoathetosis">Choreoathetosis</a></li></ul></li> <li><a href="/wiki/Myoclonus" title="Myoclonus">Myoclonus</a> <ul><li><a href="/wiki/Myoclonic_epilepsy" title="Myoclonic epilepsy">Myoclonic epilepsy</a></li></ul></li> <li><a href="/wiki/Akathisia" title="Akathisia">Akathisia</a></li></ul></li></ul> <ul><li><a href="/wiki/Tremor" title="Tremor">Tremor</a> <ul><li><a href="/wiki/Essential_tremor" title="Essential tremor">Essential tremor</a></li> <li><a href="/wiki/Intention_tremor" title="Intention tremor">Intention tremor</a></li></ul></li> <li><a href="/wiki/Restless_legs_syndrome" title="Restless legs syndrome">Restless legs</a></li> <li><a href="/wiki/Stiff-person_syndrome" title="Stiff-person syndrome">Stiff-person</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Dementia" title="Dementia">Dementia</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Tauopathy" title="Tauopathy">Tauopathy</a> <ul><li><a href="/wiki/Alzheimer%27s_disease" title="Alzheimer's disease">Alzheimer's</a> <ul><li><a href="/wiki/Early-onset_Alzheimer%27s_disease" title="Early-onset Alzheimer's disease">Early-onset</a></li></ul></li> <li><a href="/wiki/Primary_progressive_aphasia" title="Primary progressive aphasia">Primary progressive aphasia</a></li></ul></li> <li><a href="/wiki/Frontotemporal_dementia" title="Frontotemporal dementia">Frontotemporal dementia</a>/<a href="/wiki/Frontotemporal_lobar_degeneration" title="Frontotemporal lobar degeneration">Frontotemporal lobar degeneration</a> <ul><li><a href="/wiki/Pick%27s_disease" class="mw-redirect" title="Pick's disease">Pick's</a></li></ul></li> <li><a href="/wiki/Lewy_bodies_dementia" class="mw-redirect" title="Lewy bodies dementia">Lewy bodies dementia</a></li> <li><a href="/wiki/Posterior_cortical_atrophy" title="Posterior cortical atrophy">Posterior cortical atrophy</a></li></ul> <p><a href="/wiki/Creutzfeldt%E2%80%93Jakob_disease" title="Creutzfeldt–Jakob disease">Creutzfeldt–Jakob disease</a> </p> <ul><li><a href="/wiki/Vascular_dementia" title="Vascular dementia">Vascular dementia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Mitochondrial_disease" title="Mitochondrial disease">Mitochondrial disease</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Leigh_syndrome" title="Leigh syndrome">Leigh syndrome</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Demyelinating_disease" title="Demyelinating disease">Demyelinating</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/CNS_demyelinating_autoimmune_diseases" title="CNS demyelinating autoimmune diseases">Autoimmune</a></li> <li><a href="/wiki/Inflammatory_demyelinating_diseases_of_the_central_nervous_system" title="Inflammatory demyelinating diseases of the central nervous system">Inflammatory</a></li> <li><a href="/wiki/Multiple_sclerosis" title="Multiple sclerosis">Multiple sclerosis</a></li> <li>For more detailed coverage, see <a href="/wiki/Template:Demyelinating_diseases_of_CNS" title="Template:Demyelinating diseases of CNS">Template:Demyelinating diseases of CNS</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Episodic/<br /><a href="/wiki/Paroxysmal_attack" title="Paroxysmal attack">paroxysmal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Epileptic_seizure" class="mw-redirect" title="Epileptic seizure">Seizures</a> and <a href="/wiki/Epilepsy" title="Epilepsy">epilepsy</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Focal_seizure" title="Focal seizure">Focal</a></li> <li><a href="/wiki/Generalized_epilepsy" title="Generalized epilepsy">Generalised</a></li> <li><a href="/wiki/Status_epilepticus" title="Status epilepticus">Status epilepticus</a></li> <li>For more detailed coverage, see <a href="/wiki/Template:Epilepsy" class="mw-redirect" title="Template:Epilepsy">Template:Epilepsy</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Headache" title="Headache">Headache</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Migraine" title="Migraine">Migraine</a></li> <li><a href="/wiki/Cluster_headache" title="Cluster headache">Cluster</a></li> <li><a href="/wiki/Tension_headache" title="Tension headache">Tension</a></li> <li>For more detailed coverage, see <a href="/wiki/Template:Headache" title="Template:Headache">Template:Headache</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cerebrovascular_disease" title="Cerebrovascular disease">Cerebrovascular</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Transient_ischemic_attack" title="Transient ischemic attack">TIA</a></li> <li><a href="/wiki/Stroke" title="Stroke">Stroke</a></li> <li>For more detailed coverage, see <a href="/wiki/Template:Cerebrovascular_diseases" title="Template:Cerebrovascular diseases">Template:Cerebrovascular diseases</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Sleep_disorders" class="mw-redirect" title="Sleep disorders">Sleep disorders</a> <ul><li>For more detailed coverage, see <a href="/wiki/Template:Sleep" title="Template:Sleep">Template:Sleep</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cerebrospinal_fluid" title="Cerebrospinal fluid">CSF</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Intracranial_pressure" title="Intracranial pressure">Intracranial hypertension</a> <ul><li><a href="/wiki/Hydrocephalus" title="Hydrocephalus">Hydrocephalus</a></li> <li><a href="/wiki/Normal_pressure_hydrocephalus" title="Normal pressure hydrocephalus">Normal pressure hydrocephalus</a></li> <li><a href="/wiki/Choroid_plexus_papilloma" title="Choroid plexus papilloma">Choroid plexus papilloma</a></li> <li><a class="mw-selflink selflink">Idiopathic intracranial hypertension</a></li></ul></li> <li><a href="/wiki/Cerebral_edema" title="Cerebral edema">Cerebral edema</a></li> <li><a href="/wiki/Spontaneous_cerebrospinal_fluid_leak" class="mw-redirect" title="Spontaneous cerebrospinal fluid leak">Intracranial hypotension</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Brain_herniation" title="Brain herniation">Brain herniation</a></li> <li><a href="/wiki/Reye_syndrome" title="Reye syndrome">Reye syndrome</a></li> <li><a href="/wiki/Hepatic_encephalopathy" title="Hepatic encephalopathy">Hepatic encephalopathy</a></li> <li><a href="/wiki/Toxic_encephalopathy" title="Toxic encephalopathy">Toxic encephalopathy</a></li> <li><a href="/wiki/Hashimoto%27s_encephalopathy" title="Hashimoto's encephalopathy">Hashimoto's encephalopathy</a></li> <li><a href="/wiki/Fetal_alcohol_spectrum_disorder" title="Fetal alcohol spectrum disorder">Static encephalopathy</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Both/either</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Degenerative" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Neurodegenerative_disease" title="Neurodegenerative disease">Degenerative</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Spinocerebellar_ataxia" title="Spinocerebellar ataxia">SA</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Friedreich%27s_ataxia" title="Friedreich's ataxia">Friedreich's ataxia</a></li> <li><a href="/wiki/Ataxia%E2%80%93telangiectasia" title="Ataxia–telangiectasia">Ataxia–telangiectasia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Motor_neuron_diseases" title="Motor neuron diseases">MND</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Upper_motor_neuron" title="Upper motor neuron">UMN</a> only:</i> <ul><li><a href="/wiki/Primary_lateral_sclerosis" title="Primary lateral sclerosis">Primary lateral sclerosis</a></li> <li><a href="/wiki/Pseudobulbar_palsy" title="Pseudobulbar palsy">Pseudobulbar palsy</a></li> <li><a href="/wiki/Hereditary_spastic_paraplegia" title="Hereditary spastic paraplegia">Hereditary spastic paraplegia</a></li></ul></li></ul> <ul><li><i><a href="/wiki/Lower_motor_neuron" title="Lower motor neuron">LMN</a> only:</i> <ul><li><a href="/wiki/Distal_hereditary_motor_neuronopathies" title="Distal hereditary motor neuronopathies">Distal hereditary motor neuronopathies</a></li> <li><a href="/wiki/Spinal_muscular_atrophies" title="Spinal muscular atrophies">Spinal muscular atrophies</a> <ul><li><a href="/wiki/Spinal_muscular_atrophy" title="Spinal muscular atrophy">SMA</a></li> <li><a href="/wiki/Spinal_and_bulbar_muscular_atrophy" title="Spinal and bulbar muscular atrophy">SMAX1</a></li> <li><a href="/wiki/X-linked_spinal_muscular_atrophy_type_2" title="X-linked spinal muscular atrophy type 2">SMAX2</a></li> <li><a href="/wiki/Distal_spinal_muscular_atrophy_type_1" title="Distal spinal muscular atrophy type 1">DSMA1</a></li> <li><a href="/wiki/Congenital_distal_spinal_muscular_atrophy" title="Congenital distal spinal muscular atrophy">Congenital DSMA</a></li> <li>Spinal muscular atrophy with lower extremity predominance (SMALED) <ul><li><a href="/wiki/Spinal_muscular_atrophy_with_lower_extremity_predominance_1" title="Spinal muscular atrophy with lower extremity predominance 1">SMALED1</a></li> <li><a href="/wiki/Spinal_muscular_atrophy_with_lower_extremity_predominance_2A" title="Spinal muscular atrophy with lower extremity predominance 2A">SMALED2A</a></li> <li><a href="/wiki/Spinal_muscular_atrophy_with_lower_extremity_predominance_2B" title="Spinal muscular atrophy with lower extremity predominance 2B">SMALED2B</a></li></ul></li> <li><a href="/wiki/Pontocerebellar_hypoplasia" title="Pontocerebellar hypoplasia">SMA-PCH</a></li> <li><a href="/wiki/Spinal_muscular_atrophy_with_progressive_myoclonic_epilepsy" title="Spinal muscular atrophy with progressive myoclonic epilepsy">SMA-PME</a></li></ul></li> <li><a href="/wiki/Progressive_muscular_atrophy" title="Progressive muscular atrophy">Progressive muscular atrophy</a></li> <li><a href="/wiki/Progressive_bulbar_palsy" title="Progressive bulbar palsy">Progressive bulbar palsy</a> <ul><li><a href="/wiki/Fazio%E2%80%93Londe_disease" title="Fazio–Londe disease">Fazio–Londe</a></li> <li><a href="/wiki/Infantile_progressive_bulbar_palsy" title="Infantile progressive bulbar palsy">Infantile progressive bulbar palsy</a></li></ul></li></ul></li></ul> <ul><li><i>both:</i> <ul><li><a href="/wiki/Amyotrophic_lateral_sclerosis" class="mw-redirect" title="Amyotrophic lateral sclerosis">Amyotrophic lateral sclerosis</a></li></ul></li></ul> 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