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Idiopathic intracranial hypertension

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689: 507: 345:. This occurs in practically all cases of IIH, but not everyone experiences symptoms from this. Those who do experience symptoms typically report "transient visual obscurations", episodes of difficulty seeing that occur in both eyes but not necessarily at the same time. Long-term untreated papilledema leads to visual loss, initially in the periphery but progressively towards the center of vision. 671:
also require that the lumbar puncture is performed with the person lying sideways, as a lumbar puncture performed in the upright sitting position can lead to artificially high pressure measurements. Friedman and Jacobson also do not insist on MR venography for every person; rather, this is only required in atypical cases (see "diagnosis" above).
626:. In a 2001 paper, Digre and Corbett amended Dandy's criteria further. They added the requirement that the person is awake and alert, as coma precludes adequate neurological assessment, and require exclusion of venous sinus thrombosis as an underlying cause. Furthermore, they added the requirement that no other cause for the raised ICP is found. 912: 857:. A pressure valve is usually included in the circuit to avoid excessive drainage when the person is erect. LP shunting provides long-term relief in about half the cases; others require revision of the shunt, often on more than one occasion, usually due to shunt obstruction. If the lumboperitoneal shunt needs repeated revisions, a 680:
or may continue chronically. There are three main treatment approaches: weight loss, different medications and surgical interventions. Remission is seen for most patients that achieve a weight loss of around 6–10%. Bariatric surgery can be an option for those patients that don't achieve weight loss with lifestyle changes and diet.
819:. Surgery would normally only be offered if medical therapy is either unsuccessful or not tolerated. The choice between these two procedures depends on the predominant problem in IIH. Neither procedure is perfect: both may cause significant complications, and both may eventually fail in controlling the symptoms. There are no 553:. A contrast-enhanced MRV (ATECO) scan has a high detection rate for abnormal transverse sinus stenoses. These stenoses can be more adequately identified and assessed with catheter cerebral venography and manometry. Buckling of the bilateral optic nerves with increased perineural fluid is also often noted on MRI imaging. 679:
The primary goal in treatment of IIH is the prevention of visual loss and blindness, as well as symptom control. IIH is treated mainly through the reduction of CSF pressure and IIH may resolve after initial treatment, may go into spontaneous remission (although it can still relapse at a later stage),
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The procedure can be repeated if necessary, but this is generally taken as a clue that additional treatments may be required to control the symptoms and preserve vision. Repeated lumbar punctures are regarded as unpleasant by people, and they present a danger of introducing spinal infections if done
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The first step in symptom control is drainage of cerebrospinal fluid by lumbar puncture. If necessary, this may be performed at the same time as a diagnostic LP (such as done in search of a CSF infection). In some cases, this is sufficient to control the symptoms, and no further treatment is needed.
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In a 2002 review, Friedman and Jacobson propose an alternative set of criteria, derived from Smith's. These require the absence of symptoms that could not be explained by a diagnosis of IIH, but do not require the actual presence of any symptoms (such as headache) attributable to IIH. These criteria
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The second theory posits that either increased blood flow to the brain or increase in the brain tissue itself may result in the raised pressure. Little evidence has accumulated to support the suggestion that increased blood flow plays a role, but recently Bateman et al. in phase contrast MRA studies
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levels. By definition, all of these are within their normal limits in IIH. Occasionally, the CSF pressure measurement may be normal despite very suggestive symptoms. This may be attributable to the fact that CSF pressure may fluctuate over the course of the normal day. If the suspicion of problems
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The diagnosis may be suspected on the basis of the history and examination. To confirm the diagnosis, as well as excluding alternative causes, several investigations are required; more investigations may be performed if the history is not typical or the person is more likely to have an alternative
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in 1955 to distinguish it from intracranial hypertension due to life-threatening diseases (such as cancer); however, this was also felt to be misleading because any disease that can blind someone should not be thought of as benign, and the name was therefore revised in 1989 to "idiopathic (of no
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or the creation of an area of scar tissue that lowers the pressure. The effects on the intracranial pressure itself are more modest. Moreover, the procedure may lead to significant complications, including blindness in 1–2%. The procedure is therefore recommended mainly in those who have limited
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In a systematic analysis of 19 studies with 207 cases, there was an 87% improvement in overall symptom rate and 90% cure rate for treatment of papilledema. Major complications only occurred in 3/207 people (1.4%). In the largest single series of transverse sinus stenting there was an 11% rate of
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Shunt surgery was introduced in 1949; initially, ventriculoperitoneal shunts were used. In 1971, good results were reported with lumboperitoneal shunting. Negative reports on shunting in the 1980s led to a brief period (1988–1993) during which optic nerve fenestration (which had initially been
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are thirteen times more likely to develop IIH, and this figure goes up to nineteen times in women who are more than twenty percent over their ideal body weight. In men this relationship also exists, but the increase is only five-fold in those over 20 percent above their ideal body weight.
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The most common symptom of IIH is severe headache, which occurs in almost all (92–94%) cases. It is characteristically worse in the morning, generalized in character and throbbing in nature. It may be associated with nausea and vomiting. The headache can be made worse by
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There are numerous other diseases, mostly rare conditions, that may lead to intracranial hypertension. If there is an underlying cause, the condition is termed "secondary intracranial hypertension". Common causes of secondary intracranial hypertension include
729:(low blood potassium levels), which include muscle weakness and tingling in the fingers. Acetazolamide cannot be used in pregnancy, since it has been shown to cause embryonic abnormalities in animal studies. Also, in human beings it has been shown to cause 279:, a whooshing sensation in one or both ears (64–87%); this sound is synchronous with the pulse. Various other symptoms, such as numbness of the extremities, generalized weakness, pain and/or numbness in one or both sides of the face, loss of smell, and 802:
Due to the permanence of the stent and small but definite risk of complications, most experts will recommend that person with IIH must have papilledema and have failed medical therapy or are intolerant to medication before stenting is undertaken.
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intervention for IIH has increased markedly over the period between 1988 and 2002. This has been attributed at least in part to the rising prevalence of obesity, although some of this increase may be explained by the increased popularity of
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across the stenosis under general anaesthesia. In general, people are discharged the next day. People require double antiplatelet therapy for a period of up to 3 months after the procedure and aspirin therapy for up to 1 year.
463:(CSF) and blood inside the bony cranial vault. Three theories therefore exist as to why the pressure might be raised in IIH: an excess of CSF production, increased volume of blood or brain tissue, or obstruction of the 253:
About 2 per 100,000 people are newly affected per year. The condition most commonly affects women aged 20–50. Women are affected about 20 times more often than men. The condition was first described in 1897.
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The first theory, that of increased production of cerebrospinal fluid, was proposed in early descriptions of the disease. However, there is no experimental data that supports a role for this process in IIH.
3195: 563:(CSF) to exclude alternative diagnoses. If the opening pressure is increased, CSF may be removed for transient relief (see below). The CSF is examined for abnormal cells, infections, antibody levels, the 446:
On July 1, 2022, the FDA issued an update that gonadotropin-releasing hormone agonists, drugs that are approved for treating precocious puberty, may be a risk factor for developing pseudotumor cerebri.
700:-based disinfectant leaving brown colouration. In this image the person is seated upright, which can make the procedure easier to perform but makes any measurement of the opening pressure unreliable. 1774:
Farb, RI; Vanek, I; Scott, JN; Mikulis, DJ; Willinsky, RA; Tomlinson, G; terBrugge, KG (May 13, 2003). "Idiopathic intracranial hypertension: the prevalence and morphology of sinovenous stenosis".
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of the heart or the peritoneal cavity. Given the reduced need for revisions in ventricular shunts, it is possible that this procedure will become the first-line type of shunt treatment.
486:. It is not clear whether this narrowing is the pathogenesis of the disease or a secondary phenomenon. It has been proposed that a positive biofeedback loop may exist, where raised ICP ( 2744: 979:. Numerous other cases appeared in the literature subsequently; in many cases, the raised intracranial pressure may actually have resulted from underlying conditions. For instance, the 2200:
Curry WT, Butler WE, Barker FG (2005). "Rapidly rising incidence of cerebrospinal fluid shunting procedures for idiopathic intracranial hypertension in the United States, 1988-2002".
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headache symptoms but significant papilledema or threatened vision, and those who have undergone unsuccessful treatment with a shunt or have a contraindication for shunt surgery.
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in its portion behind the eye. It is not entirely clear how it protects the eye from the raised pressure, but it may be the result of either diversion of the CSF into the
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age at diagnosis is 30. IIH occurs predominantly in women, especially in the ages 20 to 45, who are four to eight times more likely than men to be affected.
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The third theory suggests that restricted venous drainage from the brain may be impaired resulting in congestion. Many people with IIH have narrowing of the
1006:. Those people in whom no tumour was found were therefore diagnosed with "pseudotumor cerebri" (a disease mimicking a brain tumor). The disease was renamed 3664: 3563: 2713: 1824:
Ahmed, RM; Wilkinson, M; Parker, GD; Thurtell, MJ; Macdonald, J; McCluskey, PJ; Allan, R; Dunne, V; Hanlon, M; Owler, BK; Halmagyi, GM (Sep 2011).
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samples and various types of brain scans have shown an increased water content of the brain tissue. It remains unclear why this might be the case.
419:, particularly the oral contraceptive pill (OCP), are not associated with IIH. A systematic review published in 2020 suggests the use of the term " 3553: 2730: 903:. In various case series, the long-term risk of one's vision being significantly affected by IIH is reported to lie anywhere between 10 and 25%. 618:
They were modified by Smith in 1985 to become the "modified Dandy criteria". Smith included the use of more advanced imaging: Dandy had required
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described in an unrelated condition in 1871) was more popular. Since then, shunting is recommended predominantly, with occasional exceptions.
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This condition is idiopathic, meaning there is no known cause. Risk factors include being overweight or a recent increase in weight.
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in the attempt to reduce the ICP is controversial. These may be used in severe papilledema, but otherwise their use is discouraged.
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too often. Repeated lumbar punctures are sometimes needed to control the ICP urgently if the person's vision deteriorates rapidly.
395:"Idiopathic" means of unknown cause. Therefore, IIH can only be diagnosed if there is no alternative explanation for the symptoms. 1666:"In Pseudotumor Cerebri, Hormonal Contraception is Not Associated, and the Diagnosis Remains Idiopathic Intracranial Hypertension" 351:
is typically normal apart from the presence of papilledema, which is seen on examination of the eye with a small device called an
1007: 550: 748:(painkillers) may be used in controlling the headaches of intracranial hypertension. In addition to conventional agents such as 3437: 896:
It is not known what percentage of people with IIH will remit spontaneously, and what percentage will develop chronic disease.
423:" after having applied a 'strict drug-causality algorithm' in determining IIH cases likely caused by the drugs they evaluated. 845:, involves the creation of a conduit by which CSF can be drained into another body cavity. The initial procedure is usually a 2952: 2928: 2758: 1133: 475:
have quantified cerebral blood flow (CBF) in vivo and suggests that CBF is abnormally elevated in many people with IIH. Both
380: 3144: 283:, are reported more rarely; none are specific for IIH. In children, numerous nonspecific signs and symptoms may be present. 899:
IIH does not normally affect life expectancy. The major complications from IIH arise from untreated or treatment-resistant
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is sometimes used for a treatment if acetazolamide is not tolerated, but this drug sometimes has little effect on the ICP.
3631: 3516: 3432: 3374: 2923: 534:(MRI), is used to exclude any mass lesions. In IIH these scans typically appear to be normal, although small or slit-like 250:
may also be used along with the above measures. A small percentage of people may require surgery to relieve the pressure.
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1 Symptoms of raised intracranial pressure (headache, nausea, vomiting, transient visual obscurations, or papilledema)
3110: 1826:"Transverse sinus stenting for idiopathic intracranial hypertension: a review of 52 patients and of model predictions" 1002:
The terms "benign" and "pseudotumor" derive from the fact that increased intracranial pressure may be associated with
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therefore experience horizontal double vision which is worse when looking towards the affected side. More rarely, the
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An MR venogram is also performed in most cases to exclude the possibility of venous sinus stenosis/obstruction or
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Nonne M (1904). "Ueber Falle vom Symptomkomplex "Tumor Cerebri" mit Ausgang in Heilung (Pseudotumor Cerebri)".
1163: 412: 383:) perimetry is recommended as other methods of testing may be less accurate. Longstanding papilledema leads to 348: 3610: 235:
may also trigger the condition. The diagnosis is based on symptoms and a high opening pressure found during a
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Venous sinus stenoses leading to venous hypertension appear to play a significant part in relation to raised
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Corbett JJ, Thompson HS (October 1989). "The rational management of idiopathic intracranial hypertension".
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Digre KB, Corbett JJ (2001). "Idiopathic intracranial hypertension (pseudotumor cerebri): A reappraisal".
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remains high, it may be necessary to perform more long-term monitoring of the ICP by a pressure catheter.
436: 367:(third, fourth, or sixth nerve palsy) or as facial nerve palsy. If the papilledema has been longstanding, 323: 311: 138: 456: 440: 3679: 3674: 3490: 3364: 3182: 3160: 3075: 2998: 2908: 2895: 2820: 776: 495: 487: 396: 213: 2671: 3427: 3244: 3133: 2545: 980: 943:
Despite several reports of IIH in families, there is no known genetic cause for IIH. People from all
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Binder DK, Horton JC, Lawton MT, McDermott MW (March 2004). "Idiopathic intracranial hypertension".
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On average, IIH occurs in about one per 100,000 people, and can occur in children and adults. The
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Tan, Marcus G.; Worley, Brandon; Kim, Whan B.; ten Hove, Martin; Beecker, Jennifer (April 2020).
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Friedman DI, Jacobson DM (2002). "Diagnostic criteria for idiopathic intracranial hypertension".
1309: 1217: 866: 730: 722: 535: 491: 483: 315: 298:(sixth nerve) is involved. This nerve supplies the muscle that pulls the eye outward. Those with 72: 2722: 829:
is an operation that involves the making of an incision in the connective tissue lining of the
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For the diagnosis, brain scans (such as MRI) should be done to rule out other potential causes.
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Foley J (1955). "Benign forms of intracranial hypertension; toxic and otitic hydrocephalus".
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Tan YJ, Choo C (2020). "Idiopathic Intracranial Hypertension – Characteristic MRI Features".
1665: 999:; Dandy also introduced subtemporal decompressive surgery in the treatment of the condition. 947:
may develop IIH. In children, there is no difference in incidence between males and females.
3412: 3283: 3278: 3063: 3058: 2491: 2456: 2421: 2384: 2376: 2352: 2315: 2271: 2209: 2172: 2131: 2123: 2068: 2037: 1970: 1962: 1910: 1847: 1837: 1783: 1732: 1677: 1636: 1620: 1579: 1563: 1524: 1440: 1388: 1380: 1293: 1201: 1068: 1060: 968: 791: 780: 303: 3334: 3025: 2703: 2112:"Idiopathic Intracranial Hypertension. A Systematic Analysis of Transverse Sinus Stenting" 984: 834: 693: 556: 543: 494:, resulting in venous hypertension (raised venous pressure), decreased CSF resorption via 360: 307: 236: 127: 2460: 2056: 3391: 3340: 3168: 2877: 2754: 2389: 2364: 2213: 2136: 2111: 1975: 1950: 1852: 1825: 1787: 1641: 1584: 1551: 1444: 1393: 1368: 1297: 1073: 1048: 956: 816: 764: 464: 352: 295: 2575: 1720: 1192:
Wakerley, BR; Tan, MH; Ting, EY (March 2015). "Idiopathic intracranial hypertension".
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Teleb, MS; Cziep, ME; Lazzaro, MA; Gheith, A; Asif, K; Remler, B; Zaidat, OO (2013).
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strongly predispose a person to IIH: women who are more than ten percent over their
2913: 2783: 2766: 996: 988: 874: 850: 842: 725:, and it reduces CSF production by six to 57 percent. It can cause the symptoms of 581: 523: 459:
states that the intracranial pressure is determined by the amount of brain tissue,
404: 368: 319: 240: 232: 17: 1313: 322:(seventh cranial nerve) is affected occasionally – the result is total or partial 246:
Treatment includes a healthy diet, salt restriction, and exercise. The medication
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Acheson JF (2006). "Idiopathic intracranial hypertension and visual function".
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Holst, Anders Vedel; Danielsen, Patricia Louise; Romner, Bertil (2011-01-31).
1141: 1064: 928: 757: 738: 364: 334: 291: 216:(pressure around the brain) without a detectable cause. The main symptoms are 166: 151: 2080: 1744: 1689: 1632: 1575: 1205: 3093: 3044: 3032: 3015: 2947: 2649: 2614: 2356: 2320: 2177: 2160: 1758: 976: 944: 745: 400: 342: 178: 65: 2503: 2433: 2425: 2398: 2329: 2221: 2186: 2145: 2088: 1984: 1922: 1861: 1795: 1697: 1650: 1593: 1536: 1452: 1305: 1213: 1082: 911: 2468: 2380: 2011: 1402: 1340: 975:. The term "pseudotumor cerebri" was introduced in 1904 by his compatriot 915:
The number of new cases per year of IIH is strongly determined by sex and
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resorption, decreased ICP, cure of papilledema and other symptoms of IIH.
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due to increased pressure) and enlargement of Meckel's caves may be seen.
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A self-expanding metal stent is permanently deployed within the dominant
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2 No localizing signs with the exception of abducens (sixth) nerve palsy
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4 Normal to small (slit) ventricles on imaging with no intracranial mass
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From national hospital admission databases it appears that the need for
275:. The pain may also be experienced in the neck and shoulders. Many have 2275: 1914: 1842: 1624: 932: 568: 564: 2528: 2127: 515:
problem: children, men, the elderly, or women who are not overweight.
47: 3312: 3053: 3020: 2717: 2555: 2540: 1951:"Intracranial pressure without brain tumor - diagnosis and treatment" 924: 697: 476: 387:, in which the disc looks pale and visual loss tends to be advanced. 318:, respectively) are affected; both play a role in eye movements. The 280: 272: 1327:
Sismanis A (July 1998). "Pulsatile tinnitus. A 15-year experience".
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The best-studied medical treatment for intracranial hypertension is
359:. If there are cranial nerve abnormalities, these may be noticed on 3568:
Spinal muscular atrophy with lower extremity predominance (SMALED)
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is performed to measure the opening pressure, as well as to obtain
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Soler D, Cox T, Bullock P, Calver DM, Robinson RO (January 1998).
919:. The figures in females are in women between 20 and 45 years old. 910: 687: 505: 268: 2619: 1664:
Lee, Brendon W. H.; Lau, Fiona S.; Francis, Ian C. (2019-07-01).
1609:"A severe case of tetracycline-induced intracranial hypertension" 1552:"Intracranial hypertension associated with topical tretinoin use" 602:
2 No localizing signs with the exception of abducens nerve palsy
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1 Signs & symptoms of increased ICP – CSF pressure >25 cmH
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Benign intracranial hypertension (BIH), pseudotumor cerebri (PTC)
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Two main surgical procedures are used for the treatment of IIH:
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The increased pressure leads to compression and traction of the
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Yadav, YadR; Parihar, Vijay; Sinha, Mallika (1 January 2010).
1369:"Diagnosis and management of benign intracranial hypertension" 696:
in progress. A large area on the back has been washed with an
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any activity that further increases the intracranial pressure
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Gasparian, Suzie; Geng, Xianzhang; Hawy, Eman (2021-09-01).
991:. Diagnostic criteria for IIH were developed in 1937 by the 664:
6 No other explanation for the raised intracranial pressure
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O and normal biochemical and cytological composition of CSF
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may be considered. These shunts are inserted in one of the
538:, dilatation and buckling of the optic nerve sheaths and " 987:
may have resulted from venous sinus thrombosis caused by
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recurrence after one stent, requiring further stenting.
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4 Normal CT/MRI findings without evidence of thrombosis
2304:"The historical development of the pseudotumor concept" 888:) can lead to resolution of the condition in over 95%. 1426: 1424: 1422: 1420: 1418: 1416: 1414: 1412: 399:
may be increased due to medications such as high-dose
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to guide the decision as to which procedure is best.
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may resolve venous hypertension, leading to improved
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The first report of IIH was by the German physician
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have shown some additional benefit for pain relief.
3489: 3466: 3457: 3450: 3405: 3355: 3327: 3298: 3264: 3226: 3215: 3181: 3159: 3084: 2894: 2885: 2871: 2831: 2774: 2765: 2629: 2522: 187: 177: 165: 157: 137: 120: 107: 99: 87: 71: 59: 37: 32: 1194:Cephalalgia: An International Journal of Headache 813:optic nerve sheath decompression and fenestration 294:and supply the face and neck. Most commonly, the 161:Healthy diet, salt restriction, exercise, surgery 1998:Smith JL (1985). "Whence pseudotumor cerebri?". 1049:"Update on Idiopathic Intracranial Hypertension" 1011:identifiable cause) intracranial hypertension". 580:The original criteria for IIH were described by 2482:Bandyopadhyay S (2001). "Pseudotumor cerebri". 2023: 2021: 1168:NORD (National Organization for Rare Disorders) 849:, which connects the subarachnoid space in the 224:, and shoulder pain. Complications may include 1556:American Journal of Ophthalmology Case Reports 721:(Diamox), which acts by inhibiting the enzyme 2738: 421:drug-induced intracranial hypertension (DIIH) 8: 1944: 1942: 1940: 324:weakness of the muscles of facial expression 212:, is a condition characterized by increased 2343:Symonds CP (1931). "Otitic hydrocephalus". 2297: 2295: 2293: 735:disruptions in the blood electrolyte levels 3463: 3454: 3223: 2891: 2882: 2771: 2745: 2731: 2723: 2519: 1504: 1502: 1500: 1498: 1496: 1494: 1492: 1490: 1128: 1126: 1124: 1122: 1120: 1118: 1116: 1114: 1112: 971:, who described it in 1893 under the name 628: 586: 349:Physical examination of the nervous system 46: 29: 2388: 2319: 2176: 2135: 2061:CONTINUUM: Lifelong Learning in Neurology 1974: 1851: 1841: 1759:https://www.fda.gov/media/159663/download 1640: 1583: 1518: 1488: 1486: 1484: 1482: 1480: 1478: 1476: 1474: 1472: 1470: 1392: 1279: 1277: 1275: 1273: 1271: 1269: 1267: 1265: 1263: 1261: 1259: 1257: 1255: 1253: 1251: 1187: 1185: 1110: 1108: 1106: 1104: 1102: 1100: 1098: 1096: 1094: 1092: 1072: 1042: 1040: 1038: 1036: 1034: 1032: 1030: 1028: 510:Ultrasound of the optic nerve showing IIH 2707:) is being considered for deletion. See 2264:Deutsche Zeitschrift fĂĽr Nervenheilkunde 2243:Quincke HI (1893). "Meningitis serosa". 1830:AJNR. American Journal of Neuroradiology 1819: 1817: 1815: 1813: 1725:American Journal of Clinical Dermatology 1249: 1247: 1245: 1243: 1241: 1239: 1237: 1235: 1233: 1231: 880:It has been shown that in obese people, 290:, a group of nerves that arise from the 1769: 1767: 1362: 1360: 1358: 1356: 1354: 1352: 1350: 1024: 3534:Distal hereditary motor neuronopathies 3207:Template:Demyelinating diseases of CNS 2057:"Idiopathic Intracranial Hypertension" 2000:Journal of Clinical Neuroophthalmology 1164:"Idiopathic Intracranial Hypertension" 1134:"Idiopathic Intracranial Hypertension" 959:over optic nerve sheath fenestration. 431:(a sleep-related breathing disorder), 82:ringing in the ears with the heartbeat 2055:Thurtell, Matthew J. (October 2019). 465:veins that drain blood from the brain 7: 3385:Idiopathic intracranial hypertension 2714:Idiopathic intracranial hypertension 2672:Idiopathic intracranial hypertension 2461:10.1001/archneur.1989.00520460025008 841:Shunt surgery, usually performed by 415:(for a variety of skin conditions). 198:Idiopathic intracranial hypertension 33:Idiopathic intracranial hypertension 983:reported by London neurologist Sir 873:, and then connected either to the 752:, a low dose of the antidepressant 655:5 LP opening pressure of >25 cmH 455:The cause of IIH is not known. The 3616:Infantile progressive bulbar palsy 2214:10.1227/01.NEU.0000163094.23923.E5 1876:"UOTW #5 - Ultrasound of the Week" 1788:10.1212/01.wnl.0000066683.34093.e2 1445:10.1212/01.wnl.0000029570.69134.1b 1298:10.1227/01.NEU.0000109042.87246.3C 326:on one or both sides of the face. 239:with no specific cause found on a 25: 3319:Template:Cerebrovascular diseases 3122:Frontotemporal lobar degeneration 2711:to help reach a consensus. â€ş 1670:American Journal of Ophthalmology 645:3 The patient is awake and alert 490:) causes venous narrowing in the 3665:Central nervous system disorders 3339:For more detailed coverage, see 3317:For more detailed coverage, see 3288:For more detailed coverage, see 3254:For more detailed coverage, see 3205:For more detailed coverage, see 2208:(1): 97–108, discussion 97–108. 2042:10.1097/00127893-200107010-00002 1967:10.1097/00000658-193710000-00002 1373:Archives of Disease in Childhood 1008:benign intracranial hypertension 737:of newborn babies. The diuretic 551:cerebral venous sinus thrombosis 329:The increased pressure leads to 210:benign intracranial hypertension 1292:(3): 538–51, discussion 551–2. 827:Optic nerve sheath fenestration 662: 653: 648: 643: 638: 633: 622:, but Smith replaced this with 610: 605: 600: 591: 1: 3632:Amyotrophic lateral sclerosis 3517:Hereditary spastic paraplegia 3375:Normal pressure hydrocephalus 113:Hypervitaminosis A, obesity, 3601:Progressive muscular atrophy 2245:Sammlung Klinischer Vorträge 2073:10.1212/CON.0000000000000770 1140:. April 2014. Archived from 821:randomized controlled trials 433:systemic lupus erythematosus 3111:Primary progressive aphasia 2496:10.1001/archneur.58.10.1699 2363:Symonds CP (January 1932). 1329:American Journal of Otology 333:, which is swelling of the 3701: 3433:Hashimoto's encephalopathy 3139:Posterior cortical atrophy 2960:Striatonigral degeneration 2811:Cavernous sinus thrombosis 1737:10.1007/s40257-019-00485-z 1568:10.1016/j.ajoc.2021.101130 863:ventriculoperitoneal shunt 847:lumboperitoneal (LP) shunt 532:magnetic resonance imaging 3685:Ailments of unknown cause 3539:Spinal muscular atrophies 3507:Primary lateral sclerosis 3365:Intracranial hypertension 3145:Creutzfeldt–Jakob disease 2161:"Lumbar peritoneal shunt" 1949:Dandy WE (October 1937). 1682:10.1016/j.ajo.2019.02.019 1065:10.1016/j.ncl.2016.08.004 1047:Wall, M (February 2017). 869:of the brain, usually by 607:3 Normal CSF composition 498:and further rise in ICP. 355:or in more detail with a 54: 45: 3606:Progressive bulbar palsy 3397:Intracranial hypotension 3380:Choroid plexus papilloma 2794:Herpesviral encephalitis 2709:templates for discussion 2116:Interventional Neurology 1511:British Medical Bulletin 1206:10.1177/0333102414534329 630:Modified Dandy criteria 413:tetracycline antibiotics 3118:Frontotemporal dementia 2804:Encephalitis lethargica 2321:10.3171/foc.2001.11.2.3 2178:10.4103/0028-3886.63778 429:obstructive sleep apnea 417:Hormonal contraceptives 371:may be constricted and 204:), previously known as 3423:Hepatic encephalopathy 2365:"Otitic hydrocephalus" 1880:Ultrasound of the Week 1138:National Eye Institute 920: 886:gastric bypass surgery 756:or the anticonvulsant 701: 511: 437:chronic kidney disease 191:2 per 100,000 per year 139:Differential diagnosis 3481:Ataxia–telangiectasia 3438:Static encephalopathy 3161:Mitochondrial disease 2999:Spasmodic torticollis 2909:Basal ganglia disease 2484:Archives of Neurology 2449:Archives of Neurology 2381:10.1136/bmj.1.3705.53 2357:10.1093/brain/54.1.55 1513:. 79–80 (1): 233–44. 914: 771:Venous sinus stenting 691: 542:" (flattening of the 509: 496:arachnoid granulation 488:intracranial pressure 397:Intracranial pressure 337:, the spot where the 214:intracranial pressure 3428:Toxic encephalopathy 3134:Lewy bodies dementia 2426:10.1093/brain/78.1.1 989:middle ear infection 981:otitic hydrocephalus 871:stereotactic surgery 779:, and stenting of a 377:Visual field testing 281:loss of coordination 3476:Friedreich's ataxia 2859:Meningoencephalitis 2799:Limbic encephalitis 2308:Neurosurgical Focus 2302:Johnston I (2001). 1613:Dermatology Reports 1385:10.1136/adc.78.1.89 631: 624:computed tomography 589: 561:cerebrospinal fluid 528:computed tomography 461:cerebrospinal fluid 403:derivatives (e.g., 222:ringing in the ears 220:, vision problems, 206:pseudotumor cerebri 126:Based on symptoms, 80:, vision problems, 18:Pseudotumor cerebri 3512:Pseudobulbar palsy 3250:Status epilepticus 3201:Multiple sclerosis 3038:Myoclonic epilepsy 2901:movement disorders 2847:Acute disseminated 2789:Viral encephalitis 2630:External resources 2276:10.1007/BF01667111 1915:10.1111/head.13931 1843:10.3174/ajnr.a2575 1625:10.4081/dr.2011.e1 1529:10.1093/bmb/ldl019 1053:Neurologic Clinics 921: 867:lateral ventricles 731:metabolic acidosis 723:carbonic anhydrase 702: 629: 587: 512: 492:transverse sinuses 484:transverse sinuses 375:may be decreased. 316:fourth nerve palsy 277:pulsatile tinnitus 258:Signs and symptoms 3650: 3649: 3646: 3645: 3642: 3641: 3446: 3445: 3351: 3350: 3290:Template:Headache 3256:Template:Epilepsy 3177: 3176: 3151:Vascular dementia 2994:Status dystonicus 2867: 2866: 2842:Encephalomyelitis 2692: 2691: 2128:10.1159/000357503 1955:Annals of Surgery 1439:(10): 1492–1495. 973:serous meningitis 937:ideal body weight 882:bariatric surgery 855:peritoneal cavity 817:cerebral shunting 668: 667: 616: 615: 457:Monro–Kellie rule 363:in the form of a 300:sixth nerve palsy 195: 194: 122:Diagnostic method 27:Medical condition 16:(Redirected from 3692: 3464: 3455: 3413:Brain herniation 3224: 3064:Intention tremor 3059:Essential tremor 2924:Postencephalitic 2892: 2883: 2772: 2753:Diseases of the 2747: 2740: 2733: 2724: 2520: 2508: 2507: 2490:(10): 1699–701. 2479: 2473: 2472: 2444: 2438: 2437: 2409: 2403: 2402: 2392: 2361:Also printed in 2360: 2340: 2334: 2333: 2323: 2299: 2288: 2287: 2270:(3–4): 169–216. 2259: 2253: 2252: 2240: 2234: 2233: 2197: 2191: 2190: 2180: 2156: 2150: 2149: 2139: 2107: 2101: 2100: 2067:(5): 1289–1309. 2052: 2046: 2045: 2025: 2016: 2015: 1995: 1989: 1988: 1978: 1946: 1935: 1934: 1898: 1892: 1891: 1889: 1887: 1872: 1866: 1865: 1855: 1845: 1821: 1808: 1807: 1771: 1762: 1755: 1749: 1748: 1716: 1710: 1709: 1661: 1655: 1654: 1644: 1604: 1598: 1597: 1587: 1547: 1541: 1540: 1522: 1506: 1465: 1464: 1428: 1407: 1406: 1396: 1364: 1345: 1344: 1324: 1318: 1317: 1281: 1226: 1225: 1189: 1180: 1179: 1177: 1175: 1160: 1154: 1153: 1151: 1149: 1130: 1087: 1086: 1076: 1044: 969:Heinrich Quincke 884:(and especially 859:ventriculoatrial 792:transverse sinus 781:transverse sinus 632: 620:ventriculography 590: 540:empty sella sign 441:Behçet's disease 304:oculomotor nerve 50: 30: 21: 3700: 3699: 3695: 3694: 3693: 3691: 3690: 3689: 3655: 3654: 3651: 3638: 3564:Congenital DSMA 3485: 3442: 3401: 3347: 3335:Sleep disorders 3323: 3300:Cerebrovascular 3294: 3260: 3217: 3211: 3173: 3155: 3080: 3026:Choreoathetosis 2899: 2876: 2863: 2827: 2761: 2751: 2712: 2693: 2688: 2687: 2625: 2624: 2531: 2517: 2512: 2511: 2481: 2480: 2476: 2455:(10): 1049–51. 2446: 2445: 2441: 2411: 2410: 2406: 2362: 2342: 2341: 2337: 2301: 2300: 2291: 2261: 2260: 2256: 2242: 2241: 2237: 2199: 2198: 2194: 2165:Neurology India 2158: 2157: 2153: 2109: 2108: 2104: 2054: 2053: 2049: 2027: 2026: 2019: 1997: 1996: 1992: 1948: 1947: 1938: 1900: 1899: 1895: 1885: 1883: 1874: 1873: 1869: 1823: 1822: 1811: 1773: 1772: 1765: 1756: 1752: 1718: 1717: 1713: 1663: 1662: 1658: 1606: 1605: 1601: 1549: 1548: 1544: 1520:10.1.1.131.9802 1508: 1507: 1468: 1430: 1429: 1410: 1366: 1365: 1348: 1326: 1325: 1321: 1283: 1282: 1229: 1191: 1190: 1183: 1173: 1171: 1162: 1161: 1157: 1147: 1145: 1132: 1131: 1090: 1046: 1045: 1026: 1021: 985:Charles Symonds 965: 909: 894: 809: 773: 715: 694:lumbar puncture 686: 684:Lumbar puncture 677: 658: 596: 588:Dandy criteria 578: 557:Lumbar puncture 544:pituitary gland 526:, usually with 521: 504: 453: 393: 361:eye examination 308:trochlear nerve 260: 237:lumbar puncture 128:lumbar puncture 103:20–50 years old 28: 23: 22: 15: 12: 11: 5: 3698: 3696: 3688: 3687: 3682: 3677: 3672: 3667: 3657: 3656: 3648: 3647: 3644: 3643: 3640: 3639: 3637: 3636: 3635: 3634: 3623: 3622: 3621: 3620: 3619: 3618: 3613: 3603: 3598: 3597: 3596: 3591: 3586: 3585: 3584: 3579: 3574: 3566: 3561: 3556: 3551: 3546: 3536: 3522: 3521: 3520: 3519: 3514: 3509: 3495: 3493: 3487: 3486: 3484: 3483: 3478: 3472: 3470: 3461: 3452: 3448: 3447: 3444: 3443: 3441: 3440: 3435: 3430: 3425: 3420: 3415: 3409: 3407: 3403: 3402: 3400: 3399: 3394: 3392:Cerebral edema 3389: 3388: 3387: 3382: 3377: 3372: 3361: 3359: 3353: 3352: 3349: 3348: 3346: 3345: 3344: 3343: 3341:Template:Sleep 3331: 3329: 3325: 3324: 3322: 3321: 3315: 3310: 3304: 3302: 3296: 3295: 3293: 3292: 3286: 3281: 3276: 3270: 3268: 3262: 3261: 3259: 3258: 3252: 3247: 3242: 3236: 3234: 3221: 3213: 3212: 3210: 3209: 3203: 3198: 3193: 3187: 3185: 3179: 3178: 3175: 3174: 3172: 3171: 3169:Leigh syndrome 3165: 3163: 3157: 3156: 3154: 3153: 3142: 3141: 3136: 3131: 3130: 3129: 3115: 3114: 3113: 3108: 3107: 3106: 3090: 3088: 3082: 3081: 3079: 3078: 3073: 3068: 3067: 3066: 3061: 3050: 3049: 3048: 3047: 3042: 3041: 3040: 3030: 3029: 3028: 3018: 3013: 3012: 3011: 3006: 3001: 2996: 2980: 2979: 2978: 2977: 2972: 2967: 2962: 2957: 2956: 2955: 2945: 2944: 2943: 2933: 2932: 2931: 2926: 2921: 2905: 2903: 2896:Extrapyramidal 2889: 2880: 2878:encephalopathy 2869: 2868: 2865: 2864: 2862: 2861: 2856: 2851: 2850: 2849: 2838: 2836: 2829: 2828: 2826: 2825: 2824: 2823: 2813: 2808: 2807: 2806: 2801: 2796: 2791: 2780: 2778: 2769: 2763: 2762: 2755:nervous system 2752: 2750: 2749: 2742: 2735: 2727: 2721: 2720: 2696: 2690: 2689: 2686: 2685: 2674: 2663: 2646: 2634: 2633: 2631: 2627: 2626: 2623: 2622: 2611: 2600: 2589: 2578: 2563: 2548: 2532: 2527: 2526: 2524: 2523:Classification 2516: 2515:External links 2513: 2510: 2509: 2474: 2439: 2404: 2375:(3705): 53–4. 2335: 2289: 2254: 2235: 2192: 2151: 2122:(3): 132–143. 2102: 2047: 2017: 1990: 1961:(4): 492–513. 1936: 1893: 1882:. 17 June 2014 1867: 1836:(8): 1408–14. 1809: 1782:(9): 1418–24. 1763: 1750: 1731:(2): 163–172. 1711: 1656: 1599: 1542: 1466: 1408: 1346: 1319: 1227: 1181: 1155: 1144:on 8 July 2019 1088: 1023: 1022: 1020: 1017: 964: 961: 908: 905: 893: 890: 808: 805: 772: 769: 714: 711: 685: 682: 676: 673: 666: 665: 661: 660: 656: 652: 651: 647: 646: 642: 641: 637: 636: 614: 613: 609: 608: 604: 603: 599: 598: 594: 577: 576:Classification 574: 520: 519:Investigations 517: 503: 500: 452: 449: 392: 389: 379:by automated ( 353:ophthalmoscope 296:abducens nerve 288:cranial nerves 259: 256: 193: 192: 189: 185: 184: 181: 175: 174: 169: 163: 162: 159: 155: 154: 141: 135: 134: 124: 118: 117: 111: 105: 104: 101: 97: 96: 91: 85: 84: 75: 69: 68: 63: 57: 56: 52: 51: 43: 42: 39: 35: 34: 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 3697: 3686: 3683: 3681: 3678: 3676: 3673: 3671: 3668: 3666: 3663: 3662: 3660: 3653: 3633: 3630: 3629: 3628: 3625: 3624: 3617: 3614: 3612: 3609: 3608: 3607: 3604: 3602: 3599: 3595: 3592: 3590: 3587: 3583: 3580: 3578: 3575: 3573: 3570: 3569: 3567: 3565: 3562: 3560: 3557: 3555: 3552: 3550: 3547: 3545: 3542: 3541: 3540: 3537: 3535: 3532: 3531: 3530: 3528: 3524: 3523: 3518: 3515: 3513: 3510: 3508: 3505: 3504: 3503: 3501: 3497: 3496: 3494: 3492: 3488: 3482: 3479: 3477: 3474: 3473: 3471: 3469: 3465: 3462: 3460: 3456: 3453: 3449: 3439: 3436: 3434: 3431: 3429: 3426: 3424: 3421: 3419: 3418:Reye syndrome 3416: 3414: 3411: 3410: 3408: 3404: 3398: 3395: 3393: 3390: 3386: 3383: 3381: 3378: 3376: 3373: 3371: 3370:Hydrocephalus 3368: 3367: 3366: 3363: 3362: 3360: 3358: 3354: 3342: 3338: 3337: 3336: 3333: 3332: 3330: 3326: 3320: 3316: 3314: 3311: 3309: 3306: 3305: 3303: 3301: 3297: 3291: 3287: 3285: 3282: 3280: 3277: 3275: 3272: 3271: 3269: 3267: 3263: 3257: 3253: 3251: 3248: 3246: 3243: 3241: 3238: 3237: 3235: 3233: 3229: 3225: 3222: 3220: 3214: 3208: 3204: 3202: 3199: 3197: 3194: 3192: 3189: 3188: 3186: 3184: 3183:Demyelinating 3180: 3170: 3167: 3166: 3164: 3162: 3158: 3152: 3149: 3148: 3147: 3146: 3140: 3137: 3135: 3132: 3128: 3125: 3124: 3123: 3119: 3116: 3112: 3109: 3105: 3102: 3101: 3100: 3097: 3096: 3095: 3092: 3091: 3089: 3087: 3083: 3077: 3074: 3072: 3071:Restless legs 3069: 3065: 3062: 3060: 3057: 3056: 3055: 3052: 3051: 3046: 3043: 3039: 3036: 3035: 3034: 3031: 3027: 3024: 3023: 3022: 3019: 3017: 3014: 3010: 3009:Blepharospasm 3007: 3005: 3002: 3000: 2997: 2995: 2992: 2991: 2990: 2987: 2986: 2985: 2982: 2981: 2976: 2973: 2971: 2968: 2966: 2965:Hemiballismus 2963: 2961: 2958: 2954: 2951: 2950: 2949: 2946: 2942: 2939: 2938: 2937: 2934: 2930: 2927: 2925: 2922: 2920: 2917: 2916: 2915: 2912: 2911: 2910: 2907: 2906: 2904: 2902: 2897: 2893: 2890: 2888: 2884: 2881: 2879: 2874: 2870: 2860: 2857: 2855: 2852: 2848: 2845: 2844: 2843: 2840: 2839: 2837: 2835: 2830: 2822: 2819: 2818: 2817: 2816:Brain abscess 2814: 2812: 2809: 2805: 2802: 2800: 2797: 2795: 2792: 2790: 2787: 2786: 2785: 2782: 2781: 2779: 2777: 2773: 2770: 2768: 2764: 2760: 2756: 2748: 2743: 2741: 2736: 2734: 2729: 2728: 2725: 2719: 2715: 2710: 2706: 2705: 2700: 2695: 2694: 2684: 2680: 2679: 2675: 2673: 2669: 2668: 2664: 2662: 2659: 2656: 2652: 2651: 2647: 2645: 2641: 2640: 2636: 2635: 2632: 2628: 2621: 2617: 2616: 2612: 2610: 2606: 2605: 2601: 2599: 2595: 2594: 2590: 2588: 2584: 2583: 2579: 2577: 2573: 2572: 2568: 2564: 2562: 2558: 2557: 2553: 2549: 2547: 2543: 2542: 2538: 2534: 2533: 2530: 2525: 2521: 2514: 2505: 2501: 2497: 2493: 2489: 2485: 2478: 2475: 2470: 2466: 2462: 2458: 2454: 2450: 2443: 2440: 2435: 2431: 2427: 2423: 2419: 2415: 2408: 2405: 2400: 2396: 2391: 2386: 2382: 2378: 2374: 2370: 2366: 2358: 2354: 2350: 2346: 2339: 2336: 2331: 2327: 2322: 2317: 2313: 2309: 2305: 2298: 2296: 2294: 2290: 2285: 2281: 2277: 2273: 2269: 2266:(in German). 2265: 2258: 2255: 2250: 2246: 2239: 2236: 2231: 2227: 2223: 2219: 2215: 2211: 2207: 2203: 2196: 2193: 2188: 2184: 2179: 2174: 2171:(2): 179–84. 2170: 2166: 2162: 2155: 2152: 2147: 2143: 2138: 2133: 2129: 2125: 2121: 2117: 2113: 2106: 2103: 2098: 2094: 2090: 2086: 2082: 2078: 2074: 2070: 2066: 2062: 2058: 2051: 2048: 2043: 2039: 2035: 2031: 2024: 2022: 2018: 2013: 2009: 2005: 2001: 1994: 1991: 1986: 1982: 1977: 1972: 1968: 1964: 1960: 1956: 1952: 1945: 1943: 1941: 1937: 1932: 1928: 1924: 1920: 1916: 1912: 1908: 1904: 1897: 1894: 1881: 1877: 1871: 1868: 1863: 1859: 1854: 1849: 1844: 1839: 1835: 1831: 1827: 1820: 1818: 1816: 1814: 1810: 1805: 1801: 1797: 1793: 1789: 1785: 1781: 1777: 1770: 1768: 1764: 1760: 1754: 1751: 1746: 1742: 1738: 1734: 1730: 1726: 1722: 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1121: 1119: 1117: 1115: 1113: 1111: 1109: 1107: 1105: 1103: 1101: 1099: 1097: 1095: 1093: 1089: 1084: 1080: 1075: 1070: 1066: 1062: 1058: 1054: 1050: 1043: 1041: 1039: 1037: 1035: 1033: 1031: 1029: 1025: 1018: 1016: 1012: 1009: 1005: 1000: 998: 995:neurosurgeon 994: 990: 986: 982: 978: 974: 970: 962: 960: 958: 953: 952:neurosurgical 948: 946: 941: 938: 934: 930: 926: 918: 913: 906: 904: 902: 897: 891: 889: 887: 883: 878: 876: 872: 868: 864: 860: 856: 852: 848: 844: 843:neurosurgeons 839: 836: 832: 828: 824: 822: 818: 814: 806: 804: 800: 796: 793: 788: 786: 782: 778: 770: 768: 766: 761: 759: 755: 754:amitriptyline 751: 747: 742: 740: 736: 732: 728: 724: 720: 719:acetazolamide 712: 710: 706: 699: 695: 690: 683: 681: 674: 672: 663: 654: 649: 644: 639: 634: 627: 625: 621: 611: 606: 601: 592: 585: 583: 575: 573: 570: 566: 562: 558: 554: 552: 547: 545: 541: 537: 533: 529: 525: 518: 516: 508: 501: 499: 497: 493: 489: 485: 480: 478: 472: 468: 466: 462: 458: 450: 448: 444: 442: 438: 434: 430: 424: 422: 418: 414: 411:), long-term 410: 406: 402: 398: 390: 388: 386: 385:optic atrophy 382: 378: 374: 373:visual acuity 370: 369:visual fields 366: 362: 358: 357:fundus camera 354: 350: 346: 344: 340: 336: 332: 327: 325: 321: 317: 313: 309: 305: 301: 297: 293: 289: 284: 282: 278: 274: 270: 266: 257: 255: 251: 249: 248:acetazolamide 244: 242: 238: 234: 229: 227: 223: 219: 215: 211: 207: 203: 199: 190: 186: 182: 180: 176: 173: 172:Acetazolamide 170: 168: 164: 160: 156: 153: 149: 148:arachnoiditis 145: 142: 140: 136: 133: 132:brain imaging 129: 125: 123: 119: 116: 115:tetracyclines 112: 110: 106: 102: 98: 95: 92: 90: 89:Complications 86: 83: 79: 76: 74: 70: 67: 64: 62: 58: 53: 49: 44: 40: 36: 31: 19: 3680:Eye diseases 3675:Neurosurgery 3652: 3626: 3525: 3498: 3459:Degenerative 3384: 3196:Inflammatory 3143: 3076:Stiff-person 2914:Parkinsonism 2887:Degenerative 2784:Encephalitis 2767:Inflammation 2757:, primarily 2702: 2676: 2665: 2648: 2637: 2613: 2602: 2591: 2580: 2565: 2550: 2535: 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Index

Pseudotumor cerebri

Specialty
Neurology
Symptoms
Headache
ringing in the ears with the heartbeat
Complications
Vision loss
Risk factors
tetracyclines
Diagnostic method
lumbar puncture
brain imaging
Differential diagnosis
Brain tumor
arachnoiditis
meningitis
Medication
Acetazolamide
Prognosis
intracranial pressure
headache
ringing in the ears
vision loss
Tetracycline
lumbar puncture
brain scan
acetazolamide
any activity that further increases the intracranial pressure

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