Slide 1: Idiopathic intracranial Hypertension - Pseudotumor Cerebri - Benign Intracranial Hypertension AskTheNeurologist.Com Author Anon
Slide 2: Definition 1. Clinical features of raised intracranial pressure (ICP) 2. Absence of space-occupying lesion (SOL) on brain imaging 3. Exclusion of other causes AskTheNeurologist.Com
Slide 3: Physiology of raised ICP AskTheNeurologist.Com
Slide 4: Epidemiology General population = 1 / 100,000 / yr Women aged 15 44 = 3.5 / 100,000 / yr Women BMI >29 = 20 / 100,000 / yr AskTheNeurologist.Com
Slide 5: Clinical features of Idiopathic Intracranial Hypertension Headache Vomiting Visual symptoms / signs Transient visual obscurations Diplopia (VIth Nerve palsy) false localising sign Enlarged blind-spot Papilledema on fundus examination Rest of neurological examination should be normal AskTheNeurologist.Com
Slide 6: Identifying papilledema Papilledema Normal AskTheNeurologist.Com
Slide 7: Conditions to Exclude SOL Hydrocephalus Venous Sinus Thrombosis Chronic Meningitis Infective Inflammatory / granulomatous Neoplastic (Carcinomatous / lymphomatous) Medical causes CO2 retention Malignant hypertension AskTheNeurologist.Com
Slide 8: How do we make the diagnosis? Clinical features of raised ICP without apparent cause Normal brain imaging Normal imaging of venous system LP (serves 3 purposes): 1. Checks pressure establishes diagnosis 2. CSF analysis excludes infectious, inflammatory and neoplastic etiologies 3. Symptomatic improvement AskTheNeurologist.Com
Slide 9: Associated Factors Female > Male Obesity Drugs Tetracyclines Vitamin A Iron Deficiency Anemia Endocrine abnormalities Hypothyroidism Hypoparathyroidism PCOS (probably independent of obesity, acne treatment) AskTheNeurologist.Com
Slide 10: Treatment Treat risk factors Weight loss Correct endocrine abnormalities Stop offending medication Medical ( decrease CSF production) Carbonic anhydrase inhibitors Furosemide Surgical CSF diversion procedures Optic nerve sheath fenestration AskTheNeurologist.Com
Slide 11: Benign Intracranial Hypertension? - No longer! May lead to irreversible visual loss Optic atrophy Normal AskTheNeurologist.Com
Slide 12: Follow up Symptoms of raised ICP Neuro-opthalmological assessment - Visual Field Testing - Fundus Examination AskTheNeurologist.Com
Slide 13: Thanks for your Attention! AskTheNeurologist.Com AskTheNeurologist.Com
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