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June 2014

Idiopathic Intracranial Hypertension: Important Questions Answered With More to Come

Author Affiliations
  • 1Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
JAMA Neurol. 2014;71(6):678-680. doi:10.1001/jamaneurol.2014.444

There have been nearly 100 articles written per year over the last 30 years about idiopathic intracranial hypertension (IIH).1 Despite these reports, many questions remain concerning IIH including a need for better understanding of the etiology and risk factors for disease development, the concern that a single measurement may not reflect the dynamic and variable nature of intracranial pressure, a lack of uniform agreement concerning medical management with diuretics, and finally a continued lack of uniform guidelines concerning the necessity and timing of surgical intervention (shunt vs optic nerve sheath decompression). Unfortunately, despite all of our best efforts, many patients ultimately lose significant amounts of vision. Additionally, in some patients, there continues to be difficulty distinguishing papilledema from pseudopapilledema.

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