Idiopathic Intracranial Hypertension
Aug 24, 2023
Idiopathic Intracranial Hypertension
Idiopathic Intracranial Hypertension (Pseudotumor Cerebri) diagnosis, pathogenesis, clinical features, investigations, and management with mnemonics for medical students and nursing students. https://ko-fi.com/townsendteaching https://amzn.to/3noYAEd https://amzn.to/3AVS1fa https://amzn.to/3NDyVC5 https://amzn.to/3AVBxUp https://amzn.to/424ztWe https://amzn.to/3LYtmx9 https://amzn.to/42sIJmW https://amzn.to/3NzTaki https://amzn.to/3HHPGZj https://amzn.to/3p8W3yq https://amzn.to/416d4qf https://amzn.to/429kz0P https://amzn.to/3VBtaqs https://amzn.to/3pbjR4E https://amzn.to/3LHAhJM https://amzn.to/416xAqH https://amzn.to/3VuR72O https://amzn.to/3VxkRvS https://amzn.to/42lhryy https://amzn.to/3p7IuiG https://amzn.to/3LxrVUJ https://amzn.to/44xDdkI https://amzn.to/3HFLI38 https://amzn.to/3nzmblC
Content
3.36 -> idiopathic intracranial hypertension is a
disorder where a high pressure in the brain
8.52 -> causes the presentation of meth symptoms this
is my little acronym for many eye issues like
15.12 -> double vision tinnitus and diffuse headaches it
classically affects high risk patients who are
21.78 -> rudely described with the three F's female fat
and 40 and it's associated with the toad drugs
28.92 -> tetracycline antibiotics like doxycycline the
oral contraceptive a vitamins or analogues like
36.6 -> Accutane and danzol which is an androgen
Agonist used in endometriosis in terms
43.2 -> of its pathophysiology iih is a disorder
of reduced cerebrospinal fluid absorption
49.92 -> usually the CSF is absorbed via the arachnoid
granulations these are folds of arachnoid matter
56.7 -> that push into the Dural sinuses acting as
one-way vowels to drain excessive CSF in I
63.3 -> IH these outflow Pathways probably have a higher
resistance which causes increased intracranial
70.02 -> pressure and the typical symptoms associated
with this moving on to its clinical features
74.88 -> remember it causes many eye issues like diplopia
also known as double vision this is because the
82.14 -> abducens nerve which controls the lateral rectus
muscle is really sensitive to high intracranial
87.84 -> pressures consequently 10 percent of patients
get a cranial nerve 6 pool Z moreover visual
93.84 -> loss altogether is a worrying complication as
the intracranial pressure increases the blood
99.36 -> supply to the optic nerve sheath gets cut
off this results in bilateral papilledema
105 -> or optic disc swelling on both sides over
time this can progress to visual loss and
110.46 -> blindness next a pulsatile tinnitus is common
in iih patients often describe hearing Rushing
117.9 -> Water or wind this is thought to represent
vascular pulsations caused by turbulence
123.3 -> in the venous sinuses under high pressure finally
the most important symptom is a headache this is
129.36 -> often a throbbing pain associated with nausea
and vomiting it's typically aggravated by
134.88 -> coughing worse in the morning and when lying
down but it should improve by upright posture
140.82 -> when investigating iih I want you to remember
three key areas of assessment firstly you should
147.6 -> always perform a thorough visual examination
this should include a physical exam to check
153 -> for a cranial nerve 6 palsy visual acuity testing
to check for any visual loss and fundoscopy to
159 -> assess for papilledemia next perform an MRI brain
this should help you exclude differentials which
165 -> might be intra-orbital or intracranial finally a
lumbar puncture should be done once you exclude a
171.06 -> space occupying lesion this classically would
show a high opening pressure which indicates
176.94 -> a high intracranial pressure too moving on
to management consider lifestyle management
182.22 -> pharmacological treatment and procedural
management now the most effective treatment
187.14 -> for idiopathic intracranial hypertension is weight
loss patients should aim to lose about five to ten
193.44 -> percent of their total body weight a low sodium
diet should be tried to prevent excessive water
198.42 -> intake finally consider eliminating causal factors
like tetracycline retinoids and excessive vitamin
205.5 -> A pharmacologically acetazolamide can be used to
decrease ESF production NSAIDs can be used to help
212.76 -> with a headache but importantly beta blockers or
calcium channel blockers should be avoided as they
218.94 -> may decrease perfusion of the optic nerve head
procedurally serial lumbar punctures can be useful
225.6 -> temporizing measures as a Prelude to surgery
CSF shunting procedures can be performed for
231.9 -> intractable headache or failed medical therapy
alternatively optic nerve sheath fenestration
238.62 -> can be performed now this is basically where
a window is cut into the nerve allowing CSF
244.68 -> to drain into the orbit to reduce papilledema
let's summarize all of this by going through
249.72 -> a couple of mnemonics idiopathic intracranial
hypertension causes meth symptoms this stands
255.72 -> for many eye issues tinnitus and diffuse headaches
it's common in the 3s on toads female fat and 40
263.64 -> using tetracycline the oral contraceptive pill
vitamin A and danzol finally you can remember
270.78 -> that you investigate iih like an MVP using an MRI
a thorough visual assessment and a lumbar puncture
279.66 -> thanks so much for watching Townsend teachings
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Source: https://www.youtube.com/watch?v=siT0PclS7F8
