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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pseudotumor cerebri is a clinical syndrome characterized by raised intracranial pressure with normal ventricular size, anatomy and position. Headache, vomiting and diplopia are the most common symptoms. Signs include those of raised intracranial pressure including papilledema and absence of focal neurological signs. A secondary cause is identifiable in 50% of children; the most common predisposing conditions are otitis media, viral infection and medications. Management is mainly directed towards identifying and treating the cause and measures to reduce the raised intracranial pressure. Though it is mostly a self limited condition, optic atrophy and blindness can occur. Oculomotor nerve palsy is very rarely associated with pseudotumor cerebri. We report a unique case of pseudotumor cerebri who had left Oculomotor palsy with sparing of the pupillary fibres, which resolved following treatment with oral acetazolamide.
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PMID:Pseudotumor cerebri with transient oculomotor palsy. 1638 55

Idiopathic intracranial hypertension results from cerebral oedema. The symptoms and signs of the condition are reviewed, especially the risks of visual failure if the condition is prolonged without adequate treatment. The most significant symptom in childhood is headache, and the most important sign is papilloedema. The difficulties of diagnosis are discussed, especially the cerebral oedema that can occur on the withdrawal of steroid therapy, and the increased intracranial pressure that may develop with minimal forms of craniostenosis. The causes of intracranial hypertension are many, and include ear infections, venous sinus thrombosis, the use of certain drugs, and as a complication of acute disseminated encephalomyelitis and Cushing's disease, and impaired renal function. The condition may remit spontaneously, but even so a careful watch must be kept on visual acuity. If treatment is needed various drugs can be tried, and if the response is unsatisfactory repeated lumbar punctures will be indicated. It is rarely necessary to consider surgical intervention such as cerebral decompression.
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PMID:Idiopathic intracranial hypertension. 1650 Jan 24

Idiopathic intracranial hypertension (IIH) is the syndrome of raised intracranial pressure without clinical, laboratory or radiological evidence of intracranial pathology. IIH is a relatively rare disease but rapidly increasing incidence is reported due to a global increasing incidence of obesity. Disease course is generally said to be self-limiting within a few months. However, some patients experience a disabling condition of chronic severe headache and visual disturbances for years that limit their capacity to work. Permanent visual defects are serious and not infrequent complications. The pathophysiology of IIH is still not fully understood. Advances in neuroimaging techniques have facilitated the exclusion of associated conditions that may mimic IIH. No causal treatment is yet known for IIH and existing treatment is symptomatic and rarely sufficient. The aim of this review is to provide an updated overview of this potentially disabling disease which may show a future escalating incidence due to obesity. Theories of pathogenesis, diagnostic criteria and treatment strategies are discussed.
Cephalalgia 2006 Apr
PMID:What is new about idiopathic intracranial hypertension? An updated review of mechanism and treatment. 1655 39

Idiopathic intracranial hypertension is common in obese women and can lead to significant visual impairment. First described more than 100 years ago, the cause of the disorder remains unknown. Despite a multitude of proposed links, the aetiology has never been established. Impairment of cerebrospinal-fluid reabsorption is the most likely underlying pathophysiological cause of the raised pressure, but this notion has yet to be proven. Cerebral venous sinus abnormalities associated with the disorder need further exploration. Although the major symptoms of headache and visual disturbance are well documented, most data for disease outcome have been from small retrospective case series. No randomised controlled trials of treatment have been done and the management is controversial. The importance of weight loss needs clarification, the role of diuretics is uncertain, and which surgical intervention is the most effective and safe is unknown. Prospective trials to examine these issues are urgently needed.
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PMID:Idiopathic intracranial hypertension. 1663 14

Few cluster-like headaches have been described. Idiopathic intracranial hypertension (IIH) presents with headaches in more than 90% of patients. We describe a male patient with new onset cluster-like headache secondary or related to IIH.
Cephalalgia 2006 Jul
PMID:Cluster-like headache secondary to idiopathic intracranial hypertension. 1677 7

Idiopathic intracranial hypertension is a secondary headache disorder characterized by headaches and visual symptoms. It most frequently occurs in obese women of childbearing age. However, many secondary causes exist, and it may affect children, men, and slim individuals. Prompt recognition, evaluation, and treatment are needed to prevent permanent visual loss.
Curr Pain Headache Rep 2007 Feb
PMID:Idiopathic intracranial hypertension. 1721 24

Pseudotumor cerebri is a disease characterized by increased intracranial pressure, often manifested by headaches, and occasionally leading to severe visual impairment or even blindness. Most cases in adolescents, as in adults, are associated with obesity. We report a 16-year-old morbidly obese adolescent girl (body mass index 42.3 kg/m(2)) with severely symptomatic pseudotumor cerebri who had progressive visual field deficits and elevated intracranial pressure (opening pressure on lumbar puncture of 50 cm H(2)O) despite intensive medical management and placement of both ventriculoperitoneal and lumboperitoneal shunts. Six months after she underwent gastric bypass surgery, she had lost 43% of her excess body weight and had had near complete regression of her visual field deficits, along with normalization of her intracranial pressures. This case demonstrates the dramatic reversal of symptoms of pseudotumor cerebri with surgically induced weight loss. Gastric bypass should be considered as a treatment option for adolescents with severe and progressive pseudotumor cerebri.
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PMID:Clinical resolution of severely symptomatic pseudotumor cerebri after gastric bypass in an adolescent. 1732 34

Idiopathic intracranial hypertension is an enigmatic disorder of elevated cerebrospinal fluid pressure. In adulthood, patients are typically obese women of childbearing age; however, in young children the clinical picture is strikingly different, indicating age-related differences in the aetiology of idiopathic intracranial hypertension. To investigate this phenomenon, we analysed the clinical details of 15 pre-pubertal children with the diagnosis of idiopathic intracranial hypertension. Evaluating the date of initial presentation, we discovered a distinct seasonal variation. Ten patients presented between November and March, thus coinciding with the typical season of paediatric viral and bacterial infections in Germany. Therefore, we suggest an association between intracranial hypertension and possibly concurrent infections in these children. Moreover, eight children presented only with ophthalmologic findings without any other obvious symptoms, raising questions regarding the incidence of undetected cases, particularly in this age group.
Cephalalgia 2007 Nov
PMID:Seasonal variation and atypical presentation of idiopathic intracranial hypertension in pre-pubertal children. 1791 6

Pseudotumor cerebri, also referred to as idiopathic intracranial hypertension, is a syndrome characterized by increased intracranial pressure and excludes underlying structural or systemic causes. Pseudotumor cerebri/idiopathic intracranial hypertension has been reported commonly in obese young women but can occur in children and adolescents. With the rise in overweight children, it is important to include this condition as a differential diagnosis, particularly when patients present with complaints of headache.
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PMID:Pseudotumor cerebri: yet another reason to fight obesity. 1817 88

Idiopathic intracranial hypertension (IIH) is a syndrome of unknown cause characterized by elevated intracranial pressure (ICP). While imaging often reveals a stenosis of the transverse sinuses, the role of this feature in IIH has been in dispute. Many patients with chronic daily headache have been found to actually be suffering from a milder form of IIH without papilledema (IIHWOP). These patients often demonstrate hypertensive B-waves and plateau-like waves upon continuous ICP monitoring. Recently, we presented modeling studies which suggest that the sinus stenosis and hypertension of IIH are physiological manifestations of a stable state of elevated pressures that exists when the transverse sinus is sufficiently collapsible. Many of the features of IIH were explained by this model but the prevalence of pathological ICP wave-forms observed in IIHWOP remained unresolved. The model presented here is a modified version of a previous model with a semi-collapsible sinus represented by a refined downstream Starling-like resistor based on experimental data. The qualitative behavior of this model is presented in terms of the collapsibility of the transverse sinus. For a sufficiently rigid sinus, there is a unique stable state of normal pressures. As the degree of collapsibility increases, there is a Hopf bifurcation, the normal state becomes unstable, low-frequency, high-amplitude ICP waves prevail, and small perturbations can lead to hypertensive ICP spikes. As the collapsibility increases further, so does the duration of the waves, until they are replaced by two stable states: one of normal pressures and one of elevated pressures. In this parameter domain, temporary perturbations can now cause permanent transitions between states. The model presented here retains the capability of our previous model to elucidate many features of IIH and additionally provides insight into the prevalence of the low-frequency, high-amplitude waves observed in IIHWOP.
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PMID:A model for idiopathic intracranial hypertension and associated pathological ICP wave-forms. 1826 74


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