Idiopathic Intracranial Hypertension

A 25 year old woman with severe obesity (BMI 57) presented with blurred vision, headaches, and pulsatile tinnitus. Neurologic examination revealed bilateral optic disk swelling and retinal hemorrhages (Panel A). MRI/MRV findings included flattened posterior globes, elevated optic nerve heads (Panel B), empty sella (Panel C), and transverse sinus stenoses, consistent with elevated intracranial pressure. Lumbar puncture confirmed an opening pressure of 55 cm H₂O (normal: 10–20 cm H₂O), leading to a diagnosis of idiopathic intracranial hypertension (IIH). Treatment with acetazolamide and weight-loss counseling improved papilledema at follow up. IIH, a condition linked to obesity, manifests with symptoms of increased intracranial pressure (e.g., headaches, vision changes) and requires prompt management to prevent permanent vision loss.

A 25 year old woman with severe obesity (BMI 57) presented with blurred vision, headaches, and pulsatile tinnitus. Neurologic examination revealed bilateral optic disk swelling and retinal hemorrhages (Panel A). MRI/MRV findings included flattened posterior globes, elevated optic nerve heads (Panel B), empty sella (Panel C), and transverse sinus stenoses, consistent with elevated intracranial pressure. Lumbar puncture confirmed an opening pressure of 55 cm H₂O (normal: 10–20 cm H₂O), leading to a diagnosis of idiopathic intracranial hypertension (IIH). Treatment with acetazolamide and weight-loss counseling improved papilledema at follow up. IIH, a condition linked to obesity, manifests with symptoms of increased intracranial pressure (e.g., headaches, vision changes) and requires prompt management to prevent permanent vision loss.