Idiopathic intracranial hypertension: from concise history to current management

Abstract

Abstract Background Idiopathic intracranial hypertension (IIH), known as benign intracranial hypertension (BIH) since the report of Quincke in 1893, was described as a rare disorder of elevated intracranial hypertension with normal cerebrospinal fluid (CSF) and without any pathology. This review describes the history, pathophysiology, management, and prognosis of IIH; hence, the clinician can provide treatment based on the known possible mechanisms. Results Headache and visual obscuration are the most typical reported manifestation of IIH. The pathophysiology remains unknown; however, some theories relate to its mechanism, including obesity and metabolic dysregulation. It was diagnosed based on Friedman's criteria diagnosis. The management of IIH, consisting of conservative (control body weight), medical treatment, and surgical treatment, aims to reduce the symptoms and maintain visual function. Conclusion The pathophysiology of IIH underlies the current approaches and management. The recurrences in 1–5 years are likely developed after treatment; thus, long-term follow-up needs to consider depending on the severity of visual loss, papilledema, and symptoms.

Keywords

• Idiopathic intracranial hypertension
• Papilledema
• Headache
• Visual obscuration