Reviewing the Recent Developments in Idiopathic Intracranial Hypertension

Abstract

There is increasing evidence and appreciation of idiopathic intracranial hypertension (IIH) in medicine. The pathological processes underlying raised intracranial pressure are being studied, with new insights found in both hormonal dysregulation and the metabolic neuroendocrine axis. These will potentially lead to novel therapeutic targets for IIH. The first consensus guidelines have been published on the investigation and management of adult IIH, and the International Headache Society criteria for headache attributable to IIH have been modified to reflect our evolving understanding of IIH. Randomized clinical trials have been published, and a number of studies in this disease area are ongoing.

Keywords: Headache; Idiopathic intracranial hypertension; Lumbar puncture; Obesity; Papilloedema; Pseudotumour cerebri; Raised ICP; Weight management.

Fig. 1

Optical coherence tomography (OCT) images showing change in disc swelling over the time period. a Infrared image of the right optic nerve at presentation; b infrared image of the right optic nerve following weight loss; c the central cross section and the amount of reduction in the retinal nerve fibre layer in the right eye. d Infrared image of the left optic nerve at presentation; e infrared image of the left optic nerve following weight loss; f the central cross section and the amount of reduction in the retinal nerve fibre layer in the left eye

Fig. 2

The disc volume segments and change in volume over the time period. Top image—latest, middle image—at presentation, bottom image—change in volume. a Right eye. b Left eye