Skip to Content

Idiopathic Intracranial Hypertension


What is idiopathic intracranial hypertension?

Idiopathic intracranial hypertension (IIH) is a condition where the pressure inside your skull is higher than normal.

What causes IIH?

The cause of IIH may not be known. It may be caused by an increased amount of cerebrospinal fluid (CSF) in your skull. CSF is a clear fluid that surrounds the brain and spinal cord and protects them from injury. IIH may happen when your body makes too much CSF or does not absorb it correctly.

What increases my risk for IIH?

  • Obesity
  • Too much vitamin A or tyramine
  • Certain medicines, such as steroids, tetracycline, or birth control pills
  • Medical conditions, such as hypertension or sleep apnea

What are the signs and symptoms of IIH?

  • Headache behind both eyes that is worse in the morning and with eye movement or straining
  • Nausea, vomiting, or dizziness
  • Pulsing or ringing in your ears
  • Temporary blind spots in one or both eyes
  • Blurred or double vision or loss of vision
  • Trouble seeing with your peripheral vision (tunnel vision)

How is IIH diagnosed?

Your caregiver will ask about your health history and your symptoms. You may need any of the following tests:

  • Eye exam: Your caregiver will check your vision and examine your eye. He may dilate the pupil and use a microscope with a strong light to look into your eyes. He may use a dye and take pictures of the inside of your eye. The dye helps the blood vessels in your eye show up better.
  • Neuro exam: Your caregiver will check how your pupils react to light. They may check your memory, your hand grasp, and your balance.
  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your head. The pictures may show fluid buildup and other problems. You may be given a dye before the pictures are taken to help caregivers see the pictures better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.
  • MRI: This scan uses powerful magnets and a computer to take pictures of your head. You may be given dye to help the pictures show up better. Tell the caregiver if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the caregiver if you have any metal in or on your body.
  • Lumbar puncture: This is a procedure where a needle is inserted in your back and into the spinal canal. This test will show how high the pressure is inside your skull. CSF may be collected and sent to a lab for tests. Caregivers may also drain CSF to relieve pressure and ease your headache.

How is IIH treated?

IIH may go away on its own. You may also need any of the following:

  • Medicines:
    • Migraine medicine: This may help decrease how much CSF you produce. This will help relieve pressure in your skull.
    • NSAIDs: These medicines decrease swelling, pain, and fever. NSAIDs are available without a doctor's order. Ask your caregiver which medicine is right for you. Ask how much to take and when to take it. Take as directed. NSAIDs can cause stomach bleeding and kidney problems if not taken correctly.
    • Acetaminophen: This medicine decreases pain. You can buy acetaminophen without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
    • Diuretics: This medicine helps decrease extra fluid that collects in your body. This will help lower the pressure in your skull. Diuretics are often called water pills. You may urinate more often when you take this medicine.
    • Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you take this medicine.
  • Surgery:
    • Optic nerve sheath surgery: A small opening is made in the sheath (cover) around the optic nerve. This allows extra CSF to drain and relieve eye pressure.
    • Spinal fluid shunt: A shunt (passageway) is placed in your brain or spinal cord to drain extra CSF into another area of the body. This helps relieve pressure in your skull.

How can I manage my symptoms?

  • Maintain a healthy weight: Ask your caregiver how much you should weigh. Ask him to help you create a weight loss plan if you are overweight.
  • Eat a variety of healthy foods: You may need to limit the amount of fats and salt you eat. You may also need to limit foods rich in vitamin A and tyramine. Foods rich in vitamin A include beef liver, sweet potatoes, carrots, tomatoes, and leafy greens. Food and drinks that are high in tyramine include cheese, pepperoni, salami, beer, and wine. Ask if you need to be on a special diet.
  • Drink liquids as directed: Ask your caregiver how much liquid to drink each day and which liquids are best for you.

What are the risks of IIH?

Even with treatment, your symptoms may return. If you have surgery, you could bleed more than expected. You may develop an infection. You may need another surgery to help relieve your symptoms. Without treatment, the pressure in your skull may continue to increase. This can cause severe headaches. Your vision may get worse and you may go blind.

When should I contact my caregiver?

Contact your caregiver if:

  • You have a fever.
  • Your headache gets worse or does not go away with treatment.
  • Your vision loss does not improve with treatment.
  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have a severe headache.
  • You suddenly cannot see.
  • You are confused or cannot think clearly.
  • You have a seizure.
  • You have sudden neck pain or cannot move your arms or legs.
  • You have trouble breathing all of a sudden.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.