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What is Idiopathic Intracranial Hypertension?
Idiopathic intracranial hypertensionis a neurological experimental condition characterized by increase in intracranial pressure likely due to obstruction in venous drain without the grounds of a aggregate , wound or hydrocephalus . Idiopathic intracranial high blood pressure usually occurs in women within the kid gestate eld predominantly in obese char . In patients affected by Idiopathic intracranial hypertension , the cerebrospinal fluid composition is usually normal ; however , the intracranial pressure is above normal terminus ad quem ( > 250 mm H2O ) . This condition can also develop in children after discontinuingcorticosteroidor after take on large dose of tetracycline .
Idiopathic intracranial high blood pressure is known by other equivalent word such aspseudotumor cerebriand benign intracranial hypertension .
Causes of Idiopathic Intracranial Hypertension
The exact case of this consideration is unknown ; however , the most recognised cause of idiopathic intracranial hypertension is obstruction in the intellectual venous outflow , which is possibly because of the venous sinus being low in size than normal .
Symptoms of Idiopathic Intracranial Hypertension
The most vulgar symptom of Idiopathic intracranial hypertension include increase intracranial press and optical magnetic disk extrusion or papilledema . Papilledema may develop bilaterally or unilaterally , which may or may not be symptomatic ab initio and is commonly observe during regular eye testing . Other symptom of Idiopathic intracranial hypertension admit :
ocular symptoms of papilledema let in :
Nonspecific symptoms of idiopathic intracranial high blood pressure let in dizziness , photopsias , disgorgement or retrobulbar pain .
Epidemiology of Idiopathic Intracranial Hypertension
Idiopathic intracranial hypertension is more uncouth among female than in males . relative incidence of idiopathic intracranial high blood pressure in normal weight women is about 1/100,000 and in corpulent women it is about 20/100,000 . This condition usually affects in the third decade of life . Rarely , idiopathic intracranial hypertension affect the pediatric patients who are not overweight . At present , there are no grounds hint predilection of this disease in a fussy race or ethnic group . Idiopathic intracranial high blood pressure is not associated with specific mortality . Morbidity rate is predominantly affiliate with effects of papilledema on optic issues .
Pathophysiology of Idiopathic Intracranial Hypertension
The exact pathophysiology of idiopathic intracranial hypertension is yet unknown . A heavy bit of discipline are being impart to get a safe agreement of the condition . The older theories state that increase in intracranial pressure is possibly due to cerebral hydrops . The newer theories state that there may be a link between impeding section in the distal transversal venous sinus and idiopathic intracranial hypertension with presence of arterial inflow accompanied by low grade stenosis of transverse fistula .
Risk Factors of Idiopathic Intracranial Hypertension
The most plebeian risks constituent include :
Diagnosis of Idiopathic Intracranial Hypertension
symptomatic criteria for idiopathic intracranial hypertension were described by Dandy in 1937 , which was redefined by Smith in 1985 . These criteria are as follows :
Diagnosis of idiopathic intracranial high blood pressure is done with the assistant of fact-finding study such as complete blood tally , tests for gauge electrolyte and bicarbonate level , full pro - coagulant profile . Neuro tomography studies are done to rule out theory of intracranial lesion and dural sinus thrombosis . MRI / MRV of the brain with atomic number 64 and lumbar puncture are helpful in right diagnosing of idiopathic intracranial hypertension . CT scan of Einstein may be considered if MRI is not available straight off . Lumbar puncture is carried out with the patient in lateral decubitus side . Cerebrospinal fluid ( CSF ) cogitation may let in the pursue trial :
Visual function tests are one of the most important tests and admit the followers :
Treatment of Idiopathic Intracranial Hypertension
pharmacological therapy for idiopathic intracranial high blood pressure include discourse with :
In advance cases of idiopathic intracranial hypertension , surgical interposition is study . These include :
Weight lossis strongly recommended in patients feign by idiopathic intracranial high blood pressure . It is give notice to practise on a regular groundwork , come a healthy dieting and a hefty life style . Bariatric surgery furnish significant benefit .
Prognosis of Idiopathic Intracranial Hypertension
Symptoms of idiopathic intracranial high blood pressure may last from a few months to several years . In most of the cases , the symptom worsen gradually . Treatment provide gradual melioration in symptoms and stabilization in symptoms after a period of sentence ; however , it does not provide complete recovery at all time . A large number of patients has persistent papilledema and increased intracranial pressure .
Complications of Idiopathic Intracranial Hypertension
Complications of idiopathic intracranial high blood pressure are primarily associated with consequence of papilledema on vision . Longstanding papilledema if leave untreated , can lead to serious complicatedness such as optic neuropathy with constriction of the visual field and color blindness . In most of the cases , the primal visual acuteness may be noted in end - stage papilledema .
Idiopathic intracranial hypertension is a condition that in the main affects rotund women in child - tolerate eld . The cardinal features of this condition are increased intracranial insistency and papilledema . The exact etiology of idiopathic intracranial hypertension is unknown . It is also be intimate by the name pseudotumor cerebri and benignant intracranial hypertension . The exact aetiology and causes of idiopathic intracranial hypertension is unreadable at nowadays . The most recognized reason of idiopathic intracranial hypertension is obstruction in the cerebral venous outflow . char who are obese and in the child bearing age must take special precaution to lose weight unit to avoid the condition and those who are pregnant must get their regular checkups done without fail to forefend it .
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