Idiopathic intracranial hypertension - External and Internal Eye
The most common presenting symptom of IIH is headache, occurring in 68% to 98% of patients. The headache may be exacerbated by coughing or straining. Other complaints may include blurred vision, loss of vision, transient obscurations, intracranial noises, and rarely diplopia, photopsia, tinnitus, pain, nausea, and photophobia. Most patients suffer some degree of vision loss, with blindness in 10% of cases.
IIH is increasing in prevalence because of its association with obesity. It has a strong association with weight gain, particularly in young women. The estimated worldwide incidence is 1-3 per 100,000 population per year. Limiting subjects to women aged 20-44 in the US who are 20% or more above their ideal body weight yields an incidence of 15-19 cases per 100,000. Female-to-male ratios of the disorder range from 4:1 to 15:1. Published frequencies of obesity in individuals with the disorder are 71% to 94%.
Several drugs have been associated with intracranial hypertension, most commonly tetracycline antibiotics, oral retinoids, and steroids. Estrogen hormones, tamoxifen, nalidixic acid, nitrofurantoin, indomethacin, rofecoxib, lithium, and cimetidine have also been associated with the disorder.
Medical problems such as systemic hypertension, polycystic ovary syndrome, diabetes mellitus, thyroid disease, ulcerative colitis, systemic lupus erythematosus, sickle cell disease, cystinosis, and renal transplant have been associated with IIH, although some of these patients may have had undiagnosed cerebral venous sinus thrombosis. Despite awareness of various risk factors in association with IIH, the pathogenesis remains unclear.
Pediatric Patient Considerations:
IIH is found in young children as well, without the same predominance of obesity and female sex as in adults and teens. Pediatric patients are more likely to present with systemic complaints such as headache, lethargy, poor appetite, and somnolence. Generally, these patients have a good prognosis and resolution of symptoms with prompt diagnosis and treatment.
G93.2 – Benign intracranial hypertension
68267002 – Benign intracranial hypertension
- Intracranial hemorrhage
- Intracranial mass lesion
- Intracranial inflammation
- Cerebral venous sinus thrombosis (see cerebral stroke)