Summary about Disease
Intracranial hypertension (IH) refers to increased pressure inside the skull. This pressure can be due to an increase in cerebrospinal fluid (CSF) volume, brain tissue volume, or blood volume within the skull. It can be a life-threatening condition if left untreated, as it can damage the brain and optic nerves. IH can be classified as either secondary (due to an underlying medical condition) or idiopathic (with no known cause), also known as Pseudotumor Cerebri.
Symptoms
Common symptoms include:
Persistent Headache: Often described as a throbbing or pressure-like headache. It is typically worse in the morning.
Vision Changes: Blurred vision, double vision (diplopia), temporary vision loss (transient obscurations), and eventual permanent vision loss if untreated.
Papilledema: Swelling of the optic disc, visible during an eye exam.
Nausea and Vomiting: Often associated with headache.
Tinnitus: Pulsatile tinnitus (ringing in the ears), which may sound like a heartbeat.
Neck Stiffness or Pain
Photophobia (sensitivity to light)
Radiculopathy (rare).
Causes
Secondary IH:
Brain tumors or lesions
Head injuries
Infections (meningitis, encephalitis)
Stroke
Venous sinus thrombosis (blood clot in the brain's venous sinuses)
Certain medications (e.g., tetracycline, excessive vitamin A, growth hormone)
Hydrocephalus (excess CSF)
Idiopathic IH (Pseudotumor Cerebri):
The exact cause is unknown, but it is more common in overweight women of childbearing age.
Hormonal factors, obesity, and certain medical conditions may play a role.
Medicine Used
Acetazolamide: A diuretic that reduces CSF production.
Topiramate: Can reduce CSF production and may help with weight loss (often used in IIH).
Furosemide: Another diuretic, sometimes used in combination with acetazolamide.
Pain relievers: For headache management (NSAIDs, acetaminophen, or, in some cases, stronger analgesics).
Steroids: In some cases, to reduce inflammation, but typically not for long-term use due to side effects.
Octreotide: This medicine works by suppressing growth hormone.
Is Communicable
No, intracranial hypertension is not a communicable disease. It is not contagious and cannot be spread from person to person.
Precautions
Weight Management: Maintaining a healthy weight is crucial, especially for those with Idiopathic IH.
Medication Review: Discuss all medications with a doctor, as some can trigger or worsen IH.
Regular Eye Exams: To monitor for papilledema and vision changes.
Limit Sodium Intake: Can help reduce fluid retention.
Follow Doctor's Instructions: Adhere to medication schedules and follow-up appointments.
Proper head and neck support while sleeping.
How long does an outbreak last?
The duration of symptoms varies greatly depending on the underlying cause, severity, and treatment.
Acute IH (e.g., due to head trauma): Symptoms may resolve within days or weeks with appropriate treatment.
Chronic IH (e.g., Idiopathic IH): Can be a long-term condition requiring ongoing management. Symptoms may fluctuate in intensity over months or years.
Without treatment, IH can lead to permanent vision loss and other neurological complications.
How is it diagnosed?
Neurological Exam: To assess vision, reflexes, and coordination.
Eye Exam: To check for papilledema and visual field defects.
Brain Imaging (MRI or CT Scan): To rule out tumors, hydrocephalus, or other structural abnormalities.
Lumbar Puncture (Spinal Tap): To measure CSF pressure and analyze the fluid for infection or other abnormalities.
Visual Field Testing: To assess peripheral vision.
Timeline of Symptoms
The onset and progression of symptoms vary:
Gradual Onset: Idiopathic IH often presents with a gradual onset of headaches and vision changes over weeks or months.
Acute Onset: Secondary IH, especially due to a sudden event like head trauma or stroke, can have a rapid onset of symptoms.
Fluctuating Symptoms: The severity of symptoms can fluctuate from day to day or even within the same day.
Progressive Vision Loss: If left untreated, vision loss can progress from temporary blurring to permanent loss over time.
Important Considerations
Early Diagnosis and Treatment: Crucial to prevent permanent vision loss and neurological damage.
Underlying Cause: Identifying and addressing the underlying cause of secondary IH is essential.
Multidisciplinary Approach: Management often involves neurologists, ophthalmologists, and neurosurgeons.
Lifestyle Modifications: Weight management, diet, and exercise can play a role in managing Idiopathic IH.
Compliance with Treatment: Adhering to medication schedules and follow-up appointments is vital for long-term management.
Surgical Interventions: In severe cases, surgery (e.g., shunt placement or optic nerve sheath fenestration) may be necessary to relieve pressure.