neurologic disorders
Idiopathic Intracranial Hypertension
Key Points
Consider idiopathic intracranial hypertension if patients, particularly women with excess body weight, have a daily generalized headache with or without visual symptoms; check visual fields and optic fundi. Diagnose based on results of brain imaging (preferably MRI with venography) and, if not contraindicated, lumbar puncture; consider chronic meningitis. Advise weight loss if needed, and treat withacetazolamideortopiramate. Do frequent ophthalmologic assessments (including quantitative visual fields) to monitor response to treatment. If vision deteriorates despite treatment, consider optic nerve sheath fenestration, shunting, or endovascular venous stenting. 