Idiopathic intracranial hypertension

IIH, or idiopathic intracranial hypertension, occurs when high pressure surrounding the brain results in symptoms like headaches and changes in vision.

Idiopathic is something unknown, while intracranial means inside the skull and hypertension is high pressure.

IIH happens from excess cerebrospinal fluid (CSF), the fluid surrounding the spinal cord and brain, that builds up in the skull. This places extra pressure on the brain and nerves in the back of the eye, known as the optic nerve.

If you experience changes in your vision, consult your eye doctor. The eye doctor can determine if your symptoms are related to IIH or other conditions. If your symptoms are due to IIH, you can get treatment.

Symptoms of IIH

The symptoms of IIH include:

• Tinnitus (ringing in the ear)
• Shoulder and neck pain
• Headaches
• Peripheral or side vision loss
• Blind spots
• Double vision
• Temporary blindness

If you notice changes in your vision or other symptoms, consult your eye doctor. IIH symptoms are usually similar to brain tumour symptoms, so it is also known as a false tumour or pseudotumour cerebri. The condition is common in women, with 19 out of 20 people with IIH being women.

Can I have IIH?

IIH is a rare condition, but some people have a higher risk of the condition. It usually affects women between 20 – 50 years. Being obese or overweight also increases the risk of IIH. You may have a higher risk if your body mass index is over 30 or you recently gained weight.

Causes of IIH

The causes of IIH remain unknown, but other types of intracranial hypertension have known causes:

• Acute intracranial hypertension results mostly from a stroke or an accident
• Chronic intracranial hypertension occurs over time, usually from a health problem such as a brain tumour, blood clot, or taking some medicines.

If your doctor cannot find a reason for the high pressure, it is known as IIH.

How can my eye doctor diagnose IIH?

Your eye doctor will perform some tests to check for IIH signs, including a dilated eye exam to check the back of your eye and a visual field test to examine your peripheral vision.

The eye doctor may also recommend visiting a neurologist, a brain doctor. The neurologist will check to ensure your symptoms aren’t from another health issue, like a brain tumour. The tests at the neurologist will include:

• A physical exam
• A lumbar puncture (spinal tap) to test the CSF
• Brian imaging like an MRI or CT scan

Treatment for IIH

IIH symptoms usually get better with treatment. The treatments include:

• Weight loss

For people who are obese or overweight and have IIH, the first treatment is weight loss. Losing 5 – 10% of your body weight can help reduce the symptoms. For example, if your weight is 200 pounds, you need to lose about 10 – 20 pounds. Your doctor can advise you on safe, sustainable weight loss options.

• Medicines

Your doctor can recommend acetazolamide in addition to weight loss. This medicine helps the body to produce less CSF.

• Surgery

If other treatments aren’t effective, the doctor may recommend surgery to help relieve the pressure. During a shunt surgery, the doctor will create a small hole and place a small tube called a shunt to drain the extra fluid around the brain into other parts of the body.

Eye surgery is also an option where the doctor makes a small hole in the covering around your optic nerve.

If you notice symptoms of IIH, you can visit Optimal Vision to have our eye doctor conduct the necessary tests to diagnose the condition and offer treatment. Feel free to call 020 7183 3725 to schedule your appointment.