What is Benign Intracranial Hypertension?

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What is Benign Intracranial Hypertension?

Also known as pseudotumor cerebri and idiopathic intracranial hypertension. The initial symptom is usually a headache which awakens the patient from sleep. Other symptoms include blurry vision, nausea, tinnitus and vomiting. Opening CSF pressure is in excess of 180 mm H2O (normal is 70-180 mm H2O).

Because of increased intracranial pressure, patients typically complain that headaches become worse when lying flat and better when standing up. Physical examination includes vision loss, sluggish pupillary reflexes to light, papilledema on funduscopy, and abducens nerve (CN 6) palsy. The pathology is unknown; could be caused by impaired CSF absorption by the arachnoid villi. May be caused by medications, trauma, oral contraceptive pills, glucocorticoids, vitamin A, and obesity.

Criteria for Diagnosis of Benign Intracranial Hypertension:

1. Presence of features of increased intracranial pressure in an alert patient.

2. Absence of focal neurological signs except for 6th nerve palsy.

3. Normal CSF exam with increased CSF opening pressure.

4. Absence of ventricular abnormality except reduced size (slit-like ventricles).


If left untreated, blindness can develop.


Lumbar puncture. MRI of the head may be normal.


First-line treatment is acetazolamide.

Additional Reading:

Basic Neurology

1. Peripheral Nervous System
2. Central Nervous System
3. The Ventricular System
4. The Spinal Cord
5. The Brain Stem
6. The Cerebellum
7. Visual Pathways
8. Diencephalon
9. Basal Ganglia
10. Cerebral Cortex
11. Sleep Disorders
12. Autonomic Nervous System
13. Cranial Nerves and Parasympathetic Ganglia
14. Cells of the Nervous System
15. Cerebrospinal fluid
16. Additional short notes on Cerebrum
17. Functions and Diseases of Cerebrum
18. Subcortical Grey Matter
19. Notes on The Spinal Cord
20. Regulation of Heart Rate by Autonomic Nervous System
21. Action Potentials, Axon Conduction, and Neuromuscular Junction
22. Types of Seizures
23. What is a Cough Reflex?
24. Notes on Congenital Prosopagnosia
25. Findings in Parkinson's Disease
26. Types of Heat Strokes
27. Types of Strokes
28. What is Benign Intracranial Hypertension?
29. What is Cauda Equina Syndrome?
30. Cranial Nerve Locations in Brain Stem
31. What is a Cluster Headache?
32. What is a Subarachnoid Hemorrhage?
33. What is a Tension Headache?

Neurology Videos

1. Video of Neurology Examination in a Clinical Setting

Medical Images

Useful Medical Images & Diagrams (link opens in a new window)

Related Topics

1. Nervous System Disorders
2. Histology of Nervous Tissue
3. Cranial Nerve Reflexes
4. Motor System Examination

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