Pseudotumor / IIH

What it is:

What Is Pseudotumor Cerebri / Idiopathic Intracranial Hypertension (IIH)?

Pseudotumor Cerebri, or Idiopathic Intracranial Hypertension (IIH), is a condition where pressure inside the skull increases without a detectable cause, mimicking the symptoms of a brain tumor. Despite normal brain imaging, the elevated pressure can lead to headaches, vision problems, and other neurological symptoms.

Who It Affects

Most common in women aged 20–50, especially those who are overweight or obese
Can occur in children and men, though less frequently
Often misdiagnosed as migraines or other neurological disorders

Symptoms of IIH

Severe headaches, often behind the eyes or at the back of the head
Vision changes: blurred vision, double vision, blind spots, or temporary blindness
Tinnitus: ringing or whooshing sound in the ears
Nausea and vomiting
Neck, shoulder, or back pain
Dizziness or balance issues
Fatigue and cognitive changes

Causes and Risk Factors

While the exact cause is unknown, contributing factors include:

Obesity
Hormonal changes
Certain medications (e.g., tetracyclines, steroids, vitamin A derivatives)
Sleep apnea
Autoimmune conditions (e.g., lupus, anemia, kidney disease)

Diagnosis

Diagnosis typically involves:

Eye exam to detect papilledema (optic nerve swelling)
MRI or CT scan to rule out tumors
Lumbar puncture to measure cerebrospinal fluid (CSF) pressure
Visual field testing to assess peripheral vision loss

Treatment Options

1. Medical Management

Acetazolamide: reduces CSF production
Topiramate: may help with weight loss and headaches
Migraine medications and NSAIDs for pain relief
Weight loss through diet, exercise, or bariatric surgery [Idiopathic…Management], [Managing I…nce Builds]

2. Surgical Options

Lumbar drain: temporary CSF relief
Ventriculoperitoneal shunt: long-term CSF diversion
Optic nerve sheath fenestration: protects vision
Venous sinus stenting: for patients with venous narrowing

Ready to Take the Next Step?

Call us at (561) 433-4444 to schedule a consultation or make an appointment.
Let our experienced doctors help you manage Idiopathic Intracranial Hypertension and protect your vision and quality of life.