Almost everyone suffers from occasional headaches. When those headaches occur daily, accompanied by blurred vision, back or neck aches and tinnitus, your G.P. may refer you to specialists for tests. One condition your G.P will wish to explore is Benign Intracranial Hypertension or Idiopathic Intracranial Hypertension (IIH) which is still quite rare. A recent study shows an incidence of 28 cases being diagnosed annually per 100 000 people; however, the condition is becoming more common due to a global rise in obesity.

Who It Affects

While this condition can be found in men and children, it is most likely to affect women in their 20s and 30s who are overweight. The reason for this is not fully understood, but there is strong evidence that hormones play a role. One hypothesis is that the hormones released from fatty tissue contribute to the condition.

Diagnosis of IIH

The diagnosis of IIH involves eliminating other possible causes of intracranial pressure.  The tests include:

Eye check: An ophthalmologist will check for swelling of the optic nerve which can be caused by a rise in pressure around the brain (intracranial pressure). 

CT and MRI: A neurologist will check these scans for abnormalities such as evidence of a previous brain injury.

Lumbar puncture: A small amount of spinal fluid will be collected and analysed to identify reasons for heightened intracranial pressure.

If these specialists find no other obvious causes for your symptoms, you will be diagnosed with IIH. 

Treatment Plan

There are a number of non-operative treatments for sufferers. These include:

• lumbar punctures to relieve pressure
• weight loss
• medications such as acetazolamide which recent clinical trials have shown can help with symptoms such as mild vision loss.

If your condition fails to improve, you will be required to see a neurosurgeon.

Surgery Options

In serious cases, especially with rapid vision loss, a neurosurgeon may operate when all non-invasive options have been exhausted. A neurosurgeon specialises in surgery of the brain and spinal cord. He or she spends up to a decade developing the skills and knowledge necessary to perform operations. 

Your neurosurgeon may recommend one of the following surgical procedures to relieve IIH symptoms:

Shunt: A tube called a shunt is used to drain away excess cerebral spinal fluid (CBS). One type, called a lumbar-peritoneal shunt, runs from the spine into the abdomen. Another type, called a ventriculoperitoneal shunt, runs from the brain into the abdomen. 

Optic Nerve Fenestration: This operation tends to be used when eyesight loss, rather than headaches, is the main symptom. A small window-like opening is created to discharge excess CBS from the optic nerve. 

Early Intervention

If you are suffering from IIH or any other neurological illness, your best chance for recovery is early intervention and management. You can rest assured that a specialist, such as a neurosurgeon, will recommend non-operative solutions where possible. Any delay in diagnosis is a risk to your future health.