What Is It?

Idiopathic intracranial hypertension (IIH) is a condition in which pressure inside the skull increases. This happens because the fluid around the brain and spinal cord (cerebrospinal fluid, or CSF) builds up. “Idiopathic” means that the exact cause is not known. If untreated, IIH can cause vision problems or even blindness.

Who Is at Risk?

You are more likely to develop IIH if you:

• Are obese.

• Are female, aged 20–50 years, and have not gone through menopause.

• Take certain medications, such as birth control pills, acne medicines, or steroids.

Symptoms

Common signs of IIH include:

• Headaches (most common symptom).

• Short episodes of temporary vision loss.

• Double vision, blurred vision, or poor side (peripheral) vision.

• Pain in the neck or shoulders.

• Nausea and vomiting.

• Hearing a pulsing or rushing sound in the ears (pulsatile tinnitus) or ringing in the ears.
  
  

How Is It Diagnosed?

Doctors may use:

• Medical history and symptoms review.

• Brain imaging: CT scan, MRI, or MRV (to look at brain veins).

• Lumbar puncture: A sample of CSF is removed to measure pressure.

• Eye exam: To check for swelling or nerve damage in the eyes.
  
  

Treatment

The goal of treatment is to reduce pressure around the brain. Options include:

Lifestyle and Medicines:

• Weight loss through diet, exercise, and salt restriction (if overweight).

• Medicines to reduce CSF production and lower pressure.

• Medicines to treat headaches.

Procedures:

• Lumbar puncture to remove extra CSF.

• Surgery to place a shunt, a small tube that drains extra fluid from the brain.
  
  

Home Care

• Follow all medication instructions carefully.

• Work on weight loss if recommended.

• Ask your doctor if your medicines affect your ability to drive or operate machinery.

• Avoid nicotine and tobacco products, including cigarettes and e-cigarettes.

• Keep all follow-up visits to monitor pressure and vision.
  
  

When to Contact Your Doctor

Call your doctor if you notice:

• Changes in vision: double vision, blurred vision, or poor peripheral vision.

• Worsening headache, nausea, or vomiting.

• Sudden vision problems.

Seek immediate help if your symptoms worsen or do not improve.

Summary

• IIH is a condition with increased pressure around the brain, often in overweight women aged 20–50.

• Symptoms include headaches, vision changes, and pulsating sounds in the ears.

• Treatment focuses on lowering pressure with medications, procedures, or weight management.

• Regular check-ups are essential to prevent vision loss.