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January 1970

Benign Intracranial Hypertension Associated With Hypervitaminosis A

Author Affiliations

From the Jefferson Medical College Hospital, Philadelphia. Dr. Feldman is now at the Department of Anatomy, Albert Einstein College of Medicine, Bronx, NY.

Arch Neurol. 1970;22(1):1-7. doi:10.1001/archneur.1970.00480190005001

MANY explanations have been proposed concerning the etiology of benign intracranial hypertension (BIH).1-109 The syndrome includes headache, papilledema, increased intracranial pressure, and occasional related visual field defects and sixth nerve palsies.1-10 The patients are alert, and the electroen-cephalogram is usually normal,11 as are the cerebrospinal fluid (CSF) protein level and cell count. Pneumoencephalogram shows a normal or small ventricular system, and no obstruction of extracerebral CSF patterns.1-7 Brain edema has been noted on biopsy, with swelling of all cellular elements.12 Papilledema can occasionally be so severe as to constitute a threat to vision.7 The majority of patients experience a self-limiting course, with rare recurrence.13

Implicated as causative factors have been the following: (1) obstruction or impairment of intracranial venous drainage7,14-28; (2) endocrine and metabolic dysfunctions,29-43 including obesity,30-33 menstrual disorders,34,35 pregnancy,36,37 menarche,38 Addison's disease,39 and hypoparathy-roidism40-42; (3) exogenously administered drugs,44-62 including adrenal steroids,44-51 female sex hormones,52-54 antibiotics,55-61 and psychotherapeutic drugs62; and

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