Resolution of idiopathic intracranial hypertension after sustained lowering of cerebrospinal fluid pressure

摘要

Idiopathic intracranial hypertension(IIH) is a syndrome of headache due to raised intracranial pressure(ICP) where the cerebrospinal fluid(CSF) is normal and there is no alternative pathology on imaging. The aetiology is unknown. This review questions many of the prevailing views regarding aetiology and treatment of IIH. It explores the concept that there is a vicious cycle of fluctuating raised ICP leading to secondary compression of the transverse sinuses and further elevation of ICP. It also raises the question as to whether this vicious cycle could be relieved by prolonged drainage of CSF as seen in Lumbar puncture induced low-pressure headache or alternatively a lumbar drain.