Idiopathic intracranial hypertension

Overview

Idiopathic intracranial hypertension, also known as pseudotumor cerebri, is characterized by an unexplained increase in pressure surrounding the brain. Its symptoms mimic those of a brain tumor, and the elevated intracranial pressure may lead to optic nerve swelling and subsequent vision impairment. 

Idiopathic intracranial hypertension happens when there is an accumulation of cerebrospinal fluid (CSF), which surrounds and cushions the spinal cord and brain. Pressure accumulates within your cranial cavity, exerting force on the optic nerve located at the rear of your eye, responsible for visual perception.

While pseudotumor cerebri can occur in individuals of various age groups, it primarily impacts women who are in their reproductive years, especially those with excess weight. Management strategies for this condition may encompass pharmaceutical therapies and surgical procedures. 

Symptoms

An abrupt, severe headache is the most typical symptom of idiopathic intracranial hypertension. Occasionally, the intensity of the headache is so excruciating that it rouses you from slumber. 

Other signs and symptoms may include:

• Loss of vision 
• Loss of side or peripheral vision 
• Double vision 
• Temporary episodes of blindness that impact one or both eyes and last only a few seconds 
• Seeing bursts of light 
• A pulsating, whooshing sound inside your head that synchronizes with your heartbeat.
• Tinnitus, or ear ringing sensation
• Lightheadedness, vomiting or nausea
• Pain in the neck, shoulder, or back
• Fatigue 

Causes

The brain and spinal cord are enveloped by cerebrospinal fluid, providing a protective cushion against potential injuries to essential tissues. This fluid is produced in the brain and subsequently absorbed into the bloodstream at a rate that typically maintains a constant pressure within the brain. 

In the case of idiopathic intracranial hypertension, cerebrospinal fluid accumulates without any identifiable cause. The increased intracranial pressure associated with pseudotumor cerebri may stem from an issue in the absorption mechanism. 

Certain cases of intracranial hypertension are linked to identifiable factors. Individuals may experience chronic intracranial hypertension due to health conditions such as brain tumors or blood clots. When a specific cause is identified, the condition is termed secondary intracranial hypertension, as opposed to idiopathic. 

Risk factors

The likelihood of developing idiopathic intracranial hypertension is higher in women compared to men. The majority of cases occur in individuals aged between 20 and 50 years.

Other risk factors for pseudotumor cerebri include:

• Being overweight: The likelihood of developing this condition increases in women of reproductive age who are obese, or with a body mass index (BMI) exceeding 30.
• Certain drugs: Secondary intracranial hypertension can be associated with certain medications, including growth hormone, tetracycline, and excessive intake of vitamin A.
• Underlying health issues: Secondary intracranial hypertension is associated with various health problems, including Addison’s disease, anemia, blood–clotting disorders, kidney disease, lupus, polycystic ovary syndrome, sleep apnea, and underactive parathyroid glands.