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In a patient with chronic headaches and visual symptoms, how should clinicians evaluate for idiopathic intracranial hypertension and navigate the growing array of medical and surgical treatment strategies?
Idiopathic intracranial hypertension, also called pseudotumor cerebri, refers to elevated intracranial pressure (ICP) with no identifiable cause.
Women of childbearing age with obesity are most commonly affected. Symptoms include headache, visual symptoms, neck or back pain, and pulsatile tinnitus. Papilledema (see ) is the most important sign, present in 95% of affected patients.
MRI rules out mass lesions and hydrocephalus and should reveal findings consistent with elevated ICP, including protrusion of the optic d…