Benign Intracranial Hypertension (BIH)
Intracranial hypertension (IH) is a condition in which the pressure of the cerebrospinal fluid (CSF), which surrounds the brain and spinal cord, increases to very high levels. Benign intracranial hypertension (BIH), also known as idiopathic intracranial hypertension (IIH), is a condition characterised by increased pressure in the brain without the presence of a tumour or infection. The cause of BIH is unknown, but may be associated with the use of certain antibiotics and overuse of vitamin A. It is most common in women 20 to 50 years of age.
Symptoms include headache, pulsating noises in the intracranial region, nausea, vomiting, ringing sound in the ears, and vision changes such as double vision, decreased vision and even blindness.
When you present to the clinic with these symptoms, your doctor orders imaging tests such as MRI or CT scans to rule out lesions in your brain. Lumbar puncture or spinal tap, where a needle is inserted into the CSF, is ordered to measure the pressure of CSF and obtain a sample for examination.
Conservative treatment involves medications to lower the cerebrospinal fluid production and steroids to reduce swelling of the brain tissues. Repeated spinal taps or lumbar puncture may be performed to remove excess cerebrospinal fluid. Surgery involves shunting to divert excess CSF to the abdomen or optic nerve sheath fenestration, which involves creating an outlet for discharge of excess cerebrospinal fluid from the optic nerve (nerve that supplies vision).