What is iih

Weight loss. For people who are overweight or obese and have IIH, weight loss is usually the first treatment. Losing about 5 to 10 percent of your body weight can help lessen your symptoms — for example, if you weigh pounds, that means losing about 10 to 20 pounds.

Talk with your doctor about safe, sustainable ways to lose weight. Your doctor may recommend a medicine called acetazolamide Diamox in addition to weight loss. This medicine helps your body make less CSF. In shunt surgery, doctors make a small hole and add a thin tube, called a shunt, to help extra fluid drain from around your brain into the rest of your body.

There is also an eye surgery where doctors make a small hole in the covering around the optic nerve. This trial helped to prove that acetazolamide, along with a weight loss plan, can help to restore some vision in people with IIH.

It also helped create clear guidelines for doctors on how to prescribe acetazolamide for patients with IIH. Search the site. Print this Page. Idiopathic Intracranial Hypertension.

On this page:. Testing by the ophthalmologist may include visual fields and special photography including optical coherence tomography OCT. If symptoms of headaches or optic nerve swelling if found, an MRI of the brain and MRV of the venous system will be ordered. Then, if the MRI does not show structural changes, a lumbar puncture spinal tap is performed to determine the pressure as well as content of the CSF.

High opening pressure on the lumbar puncture will diagnose IIH. After the MRI and the lumbar puncture, usually a diuretic medication called Diamox is used to decrease the pressure. Lasix and Topamax are sometimes used as well.

In very severe cases of papilledema, sometimes steroids are used. Occasionally, in very severe cases, surgery to shunt the CSF fluid or surgery to protect the optic nerve optic nerve sheath fenestration are performed. Any secondary causes are also treated. The ophthalmologist monitors vision and resolution of papilledema to determine if treatment is working. Neurology and sometimes neurosurgery teams will also be involved in managing the IIH. The most important thing anyone can do to improve IIH is to lose weight if they are obese.

Ask your doctor about local resources and clinics designed to assist you in your weight loss. As many as 10 percent of the people with pseudotumor cerebri experience progressively worsening vision and may eventually become blind. Even if symptoms have resolved, a recurrence can occur months or even years later. It is important to have regular follow-up eye examinations. Eye Terms. Eye Conditions.

The most prominent symptom is headache. This can be severe and is a long-term chronic headache. It can vary in its location and may come and go. Some people can feel sick or be sick vomit with the headache. You may also notice tinnitus in one or both of your ears. This is typically a pulsating, rhythmic sound that you can hear in your ear. You may also notice some temporary sight visual disturbance or temporary loss of vision.

For example, you may have dimming or loss of your vision in one or both of your eyes, lasting for a few seconds. This can sometimes come on after bending over. You may have some double vision when looking from side to side, or pain behind the eyes on eye movement. You may also notice a progressive permanent loss of vision in one or both of your eyes. They may examine your eyes with a hand-held instrument for looking in the back of the eye an ophthalmoscope.

This may show swelling at the back of the eye papilloedema. However, not everyone with IIH has papilloedema. Papilloedema is a sign of raised pressure within the skull raised intracranial pressure. Therefore, the main thing when diagnosing IIH is to rule out other causes of raised pressure within the skull. These may include problems such as water on the brain hydrocephalus or a brain tumour. Your doctor will usually refer you to a specialist for investigations to rule out other causes.

You may also have a more detailed eye examination. This will allow an eye specialist to examine the back of your eyes fully. You may have visual field testing to see if there are any signs of loss of vision in parts of one or both of your eyes.

Your visual field is the area in front of your eye in any part of which an object can be seen without moving your eye. You may have your colour vision tested, as this can also be affected in IIH. You may also have tests on your CSF by doing a lumbar puncture. A lumbar puncture - sometimes called a spinal tap - is a procedure where a sample of CSF is taken for testing.

A needle is pushed through the skin and tissues between two vertebrae and into the subarachnoid space around the spinal cord which is filled with CSF. See the separate leaflet called Lumbar Puncture Spinal Tap for more details. If you are diagnosed with IIH, it is important that your vision be closely monitored to look for any changes or early signs of loss of vision. This can be done by regularly measuring your 'visual acuity' the size of letters that can be read on a wall chart , along with checking your visual fields.

Any signs of deterioration in your vision can mean that your treatment needs to be adjusted. Essentially, treatment for IIH aims to prevent any deterioration in vision. However, treatment also aims to reduce other symptoms such as headaches. If you do not have any loss of vision, the usual treatment for IIH is with a group of medicines called carbonic anhydrase inhibitors.

Commonly a medicine called acetazolamide is used. These medicines help to lower the pressure within the skull, probably by reducing the production of CSF. Furosemide is another medicine used. Various painkillers may also be used to help relieve headaches. A short course of steroid tablets is also sometimes used.

Treatment with medicines can work well for many people. However, if your symptoms do not improve with medical treatment or you have new loss of vision, surgery may be considered. Surgery aims to reduce the pressure within the skull intracranial pressure. There are two main procedures that are done. The first is to put in place a tube called a shunt to drain away the excess CSF.