What Is Idiopathic Intracranial Hypertension?

Benign intracranial hypertension, also known as primary intracranial hypertension, pseudodocerebri tumor, is characterized by increased intracranial hypertension. It often starts with headache, and can be accompanied by nausea and vomiting. The disease is more common in obese, adolescent or young women. It is reported that more than 90% of patients are women, and more than 90% of patients are obese. In the United States, the prevalence rate is 1 / 100,000 per year in the general population, but 19 / 100,000 per year in obese women aged 20-44 (Durcan et al., 1988).

Benign intracranial hypertension

Introduction to Benign Intracranial Hypertension

Benign intracranial hypertension, also known as primary intracranial hypertension, pseudodocerebri tumor, is characterized by increased intracranial hypertension. It often starts with headache, and can be accompanied by nausea and vomiting. The disease is more common in obese, adolescent or young women. It is reported that more than 90% of patients are women, and more than 90% of patients are obese. In the United States, the prevalence rate is 1 / 100,000 per year in the general population, but 19 / 100,000 per year in obese women aged 20-44 (Durcan et al., 1988).

Benign intracranial hypertension symptoms and signs

The most common clinical symptoms are headache (94%); followed by transient blurred vision (68%); pulsatile intracranial noise (58%); diplopia (38%, mostly horizontal) or blindness (30%) .

Headaches can be frontotemporal (common) or occipital dull or cuff-like pain; they can be diffuse or unilateral. Common signs are varying degrees of fundus optic disc edema, and unilateral or bilateral abductor nerve palsy may also be present. Peripheral visual field, especially the reduction of the nasal or subnasal visual field and the enlargement of blind spots are also common. Due to alertness and early diagnosis of this disease in recent years, a considerable number of patients have no or only mild fundus edema. Other neurological examinations and mental states are normal.

CT or MRI examination of the brain parenchyma is normal, the shape and size of the ventricle should be normal or slightly reduced (ventricular stenosis), the sphenoidal saddle may be enlarged and filled with cerebrospinal fluid (empty sphenoidal). All patients had increased cerebrospinal fluid (CSF) pressure during lumbar puncture examination, and the pressure increase was mostly 250 450mmH2O.

Diagnosis of benign intracranial hypertension

Diagnostic criteria for benign intracranial hypertension

1. There are symptoms and signs of increased intracranial pressure.

2. Nerve examination showed no localized signs.

3. Except for the increase of cerebrospinal fluid pressure, there is no abnormality in neuro-diagnostic examination (no deformation, displacement or obstruction of ventricle system).

4. The patient is conscious.

5. There are no other causes that can cause increased intracranial pressure.

6. If the cerebrospinal fluid examination is abnormal, the diagnosis is unsuccessful.

Laboratory tests for benign intracranial hypertension

1. The cerebrospinal fluid examination pressure is generally higher than 200mmH2O, and the CSF routine laboratory examination is usually normal.

2. Necessary and selective examinations The blood routine, blood electrolytes, blood glucose, and immune items are selected based on the possible etiology, which is of differential diagnosis significance.

Other auxiliary examinations of benign intracranial hypertension

1. For chronic intracranial hypertension syndrome, plain radiographs of the skull can reveal sphenoid saddles, especially the destruction or absorption of the bones in the back of the saddle and the anterior and posterior beds. .

2. For those patients with objective signs of increased intracranial pressure or positive findings of neurological examination or clinically suspected of increased intracranial pressure, early CT or MRI should be performed.