Idiopathic intracranial hypertension

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Idiopathic intracranial hypertension

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Questions

USMLE® Step 1 style questions USMLE

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A 25-year-old woman comes to the clinic because of recurrent, pulsating headaches and transient vision changes for the past week. She initially gained relief from taking non-steroidal anti-inflammatory medications, but they are no longer sufficient due to the worsening of her symptoms. Her current medications include the combined oral contraceptive pill and a tetracycline for acne. Her temperature is 37.2°C (98.9°F), pulse is 88/min, respirations are 12/min, and blood pressure is 138/82 mm Hg. Her BMI is 32 kg/m2. A focused neurological examination shows papilledema during fundoscopy, and testing of visual fields reveals some peripheral constriction. Magnetic resonance imaging is obtained and shows flattening of the posterior sclera and reduced soft tissue occupying the sella turcica. The brain parenchyma and ventricles appear normal. Which of the following is the most likely diagnosis?  

External References

First Aid

2024

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Acetazolamide p. 251, 568, 624

pseudotumor cerebri p. 536

Danazol p. 676

pseudotumor cerebri p. 536

Idiopathic intracranial hypertension p. 536

Pseudotumor cerebri p. 536

acetazolamide for p. 624

vitamin A toxicity p. 64

Tetracyclines p. 189

pseudotumor cerebri and p. 536

Topiramate

pseudotumor cerebri p. 537

Vitamin A (retinol) p. 63, 64

pseudotumor cerebri p. 537

Weight loss

pseudotumor cerebri treatment p. 536

Summary

Idiopathic intracranial hypertension (IIH) also known as pseudotumor cerebri, is a neurological condition characterized by an increased intracranial pressure, without evidence of a space-occupying lesion or hydrocephalus on brain imaging. It causes symptoms like headache, tinnitus, and visual disturbances like diplopia.

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