"weight loss in patients with a BMI >30 kg/m2"
"The older term benign intracranial hypertension is generally discouraged due to the fact that some patients with idiopathic intracranial hypertension have a fairly aggressive clinical picture with rapid visual loss."
"Interestingly, as it has become evident that at least some patients present with IIH due to identifiable transverse sinus stenosis, some authors advocate reverting to the older term pseudotumour cerebri, as in these patients the condition is possibly not idiopathic 15. An alternative approach is to move these patients into a group termed secondary intracranial hypertension 15."
"Interestingly, as it has become evident that at least some patients present with IIH due to identifiable transverse sinus stenosis, some authors advocate reverting to the older term pseudotumour cerebri, as in these patients the condition is possibly not idiopathic 15. An alternative approach is to move these patients into a group termed secondary intracranial hypertension 15."
"Modified Dandy criteria"
"Revised Friedman criteria"
"Meckel cave enlargement 9,18 (but sometimes it is narrowed 39)"
"weight loss in patients with a BMI >30 kg/m2"
Expected headings
"Modified Dandy criteria"
"Revised Friedman criteria"
"Associations"
"Angiography (DSV)"
"absence of deformity, displacement, or obstruction of the ventricular system and otherwise normal neurodiagnostic studies, except for evidence of increased CSF pressure*; abnormal neuroimaging except for empty sella turcica, optic nerve sheath with filled-out CSF spaces, and smooth-walled non-flow-related venous sinus stenosis or collapse should lead to another diagnosis"
"Papilloedema is the hallmark finding on fundoscopic examination; it is typically bilateral but may be unilateral or even absent, making the clinical diagnosis difficult 6. Neurological examination otherwise may reveal visual loss (peripheral visual field constriction, or later loss of visual acuity), or a false-localising sixth cranial nerve palsy."
"Lumbar puncture is central to diagnosis. The CSF composition is normal but the opening pressure is elevated (with 20-25 cm H2O considered equivocal and >25 cm H2O considered definitely abnormal). It is controversial whether positioning during lumbar puncture is clinically important, with some insisting that lateral decubitus is the most accurate, while others believe that the default position for fluoroscopy-guided lumbar puncture, prone, is close enough 25. It should also be noted that opening pressure can vary during the day; indeed, one study that continuously measured CSF pressure demonstrated that many patients had intermittent pressure waves with amplitudes of 50-80 mmHg (68-109 cm H2O) that lasted 5 to 20 minutes 26."
"Aberrant arachnoid granulations, also referred to as meningoceles, can result in secondary CSF leaks that can present as rhinorrhoea, otorrhoea, intracranial hypotension, and recurrent bacterial meningitis 7,9. In such patients, it is often only after dural repair that intracranial hypertension becomes evident; presumably, the CSF leak from the meningocele normalised pressure 9."
"optic nerve head enhancement (~45%, range 10-80%; more sensitively detected by contrast-enhanced 3D T2-weighted FLAIR) 36"
"neuroimaging: no hydrocephalus, mass, structural lesion, or abnormal meningeal enhancement on MRI (without and with contrast) and, if not female or obese, MRV (if MRI is unavailable or contraindicated, contrast-enhanced CT may be used)"
"Aberrant arachnoid granulations, also referred to as meningoceles, can result in secondary CSF leaks that can present as rhinorrhoea, otorrhoea, intracranial hypotension, and recurrent bacterial meningitis 7,9. In such patients, it is often only after dural repair that intracranial hypertension becomes evident; presumably, the CSF leak from the meningocele normalised pressure 9."
"The pathogenesis is poorly understood. Various mechanisms have been proposed, including decreased CSF absorption, increased CSF production, increased intravascular volume, increased intracranial venous pressure, hormonal changes, altered aquaporin-4 channels, and abnormalities in the function of the glymphatic system 1,15,32-34."
"significant bilateral transverse sinus narrowing due to any combination of arachnoid granulations (focal, most commonly at the lateral aspect near the transverse-sigmoid sinus junction), extrinsic compression (segmental, which can be relieved after CSF withdrawal 11,12), or hypoplasia/aplasia (diffuse), not related to current or remote thrombosis 8"
"index of transverse sinus stenosis ≥4: the index is the product of stenosis grades on the left and right sides, where 0 = normal, 1 = stenosis up to one-third (66%), and 4 = hypoplasia defined as full-length transverse sinus diameter less than one-third of the superior sagittal sinus 5,28,42"
"combined venous conduit patency score ≤4: the score is the sum of patency grades on the left and right transverse-sigmoid conduit, where 4 = normal (75-100% of the diameter of the distal superior sagittal sinus), 3 = mild stenosis (50-75% patent), 2 = moderate stenosis (25-50% patent), 1 = severe stenosis or hypoplasia ("
"~80% improved headache 14,35, ~95% improved tinnitus 14,35, ~90% improved papilloedema 14,35, ~90% improved visual symptoms 35"
"Additionally, in patients with prominent cerebellar tonsillar ectopia, the possibility that all findings are, in fact, due to a Chiari 1 malformation should be considered, particularly given the substantial overlap in the demographics and clinical presentation of the two patient groups 16,19. It has even been suggested that some cases of symptomatic intracranial hypertension are secondary to a Chiari 1 malformation 20. Importantly, however, every attempt should be made to distinguish between the two entities, as treatment is different and symptom relief for patients with idiopathic intracranial hypertension with posterior fossa decompression is insignificant 21."
"serial CSF letting or CSF shunting (e.g. ventriculoperitoneal shunt, lumboperitoneal shunt)"