title: Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions.
abstract: 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.
authors.affiliation: Neurometabolism Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Keira A
authors.initials: KA
authors.lastname: Markey
authors.affiliation: Neurometabolism Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK; Birmingham Neuro-Ophthalmology Unit, Ophthalmology Department, University Hospitals Birmingham NHS Trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK.
authors.forename: Susan P
authors.initials: SP
authors.lastname: Mollan
authors.affiliation: Danish Headache Centre, Department of Neurology, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Rigmor H
authors.initials: RH
authors.lastname: Jensen
authors.affiliation: Neurometabolism Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK. Electronic address: a.b.sinclair@bham.ac.uk.
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: Sinclair
mesh_terms: D000818:Animals; D032882:Comprehension; D019468:Disease Management; D005544:Forecasting; D006801:Humans; D019586:Intracranial Hypertension / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D009765:Obesity / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D011559:Pseudotumor Cerebri / Q000150:complications / Q000175:diagnosis / Q000628:therapy