Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions

Lancet Neurol. 2016 Jan;15(1):78-91. doi: 10.1016/S1474-4422(15)00298-7. Epub 2015 Dec 8.


Idiopathic intracranial hypertension is a disorder characterised by raised intracranial pressure that predominantly affects young, obese women. Pathogenesis has not been fully elucidated, but several causal factors have been proposed. Symptoms can include headaches, visual loss, pulsatile tinnitus, and back and neck pain, but the clinical presentation is highly variable. Although few studies have been done to support evidence-based management, several recent advances have the potential to enhance understanding of the causes of the disease and to guide treatment decisions. Investigators of the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) reported beneficial effects of acetazolamide in patients with mild visual loss. Studies have also established weight loss as an effective disease-modifying treatment, and further clinical trials to investigate new treatments are underway. The incidence of idiopathic intracranial hypertension is expected to increase as rates of obesity increase; efforts to reduce diagnostic delays and identify new, effective approaches to treatment will be key to meeting the needs of a growing number of patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Comprehension*
  • Disease Management*
  • Forecasting
  • Humans
  • Intracranial Hypertension / complications
  • Intracranial Hypertension / diagnosis*
  • Intracranial Hypertension / therapy*
  • Obesity / complications
  • Obesity / diagnosis
  • Obesity / therapy
  • Pseudotumor Cerebri / complications
  • Pseudotumor Cerebri / diagnosis
  • Pseudotumor Cerebri / therapy