Thursday, 7 October 2010

MRCP revision battle 26.4: Benign intracranial hypertension

Benign intracranial hypertension classically affects overweight young females.

It presents like there should be a mass in the brain, but none can be found.

Features include:
  • headache
  • blurred vision
  • dizziness
  • horizontal diplopia
  • papilloedema

Benign intracranial hypertension is associated with:
  • COC
  • steroids
  • tetracyclines
  • vitamin A
  • nitrofurantoin
  • isontertinoin
  • danazol

Management is:
  • weight loss
  • acetazolamide
  • loop diuretics
  • prednisolone
  • therapeutic lumbar puncture
  • shunt

Note that up to 10% of patients have permanent significant vision loss - so its name of 'benign' is a little misleading!  Optic nerve sheath fenestration can help prevent this.

Onwards for a spot of coarctation of the aorta...