Idiopathic intracranial hypertension (IIH) is increased pressure around your brain. It occurs when cerebrospinal fluid (CSF), the liquid that cushions your spinal cord and brain, builds up in your skull. Pressure builds up in your brain and on your optic nerve, the nerve at the back of your eye that helps you see.

The word idiopathic means “no known cause.” Intracranial means “in the skull,” and hypertension means “high pressure.”

An outdated name for idiopathic intracranial pressure is pseudotumor cerebri. Pseudotumor cerebri means false brain tumor. IIH used to sometimes be called pseudotumor cerebri because the symptoms can be similar to brain tumor symptoms.

Causes: 

Some intracranial hypertension occurs because of known causes. Some people have chronic (long-lasting) intracranial hypertension because of health conditions like brain tumors or blood clots. Acute (sudden) intracranial hypertension can occur after a:

• Brain abscess (collection of pus and swelling in the brain).
• Head injury or traumatic brain injury (TBI).
• Stroke.

  If you have idiopathic intracranial hypertension, that means CSF builds up for no known reason. This type can affect anyone but is most common in younger women who carry excess weight.

Symptoms: 

The most common sign of intracranial hypertension is a sudden, severe headache. Sometimes the headache is so painful that it wakes you from sleep. People with IIH may also have a change in vision. You might see double or have sudden blind spots. Several conditions can cause these symptoms, so check with your provider to find out if symptoms are related to IIH or another condition.

Treatment: 

For most people, intracranial hypertension symptoms improve with treatment. Your provider may recommend:

• Weight loss: If you have a high BMI, weight loss can reduce IIH symptoms. Your healthcare provider may recommend losing 5% to 10% of your body weight.
  
  
• Medication: Some medicines manage IIH symptoms. Your provider may prescribe acetazolamide (Diamox®) or topiramate to help your body produce less CSF. You may also take a diuretic (water pill) to decrease fluid retention.
  
  
• Surgery: In severe cases, you may need surgery for IIH. Your provider may recommend a spinal fluid shunt. A shunt is a long, thin tube placed in your brain to drain excess CSF. Or you may have an eye surgery called optic nerve sheath fenestration. Your provider makes small incisions around your optic nerve to allow better CSF drainage.