Intracranial hypertension syndrome

Intracranial hypertension syndrome describes a state of elevated pressure inside the skull, marked by papilledema, swelling of the optic disc, together with headache and sometimes abducens nerve palsy, in the absence of a space occupying brain lesion and with normal cerebrospinal fluid composition. Normal intracranial pressure in a supine adult runs from about 7 to 15 millimeters of mercury, treatment is usually considered once pressure reaches 15 to 20, and readings of 20 to 25 are regarded as an upper limit requiring intervention. Patients often report morning headaches severe enough to disturb sleep, visual disturbances from optic disc swelling, pulsatile tinnitus, double vision, and reduced visual acuity, along with occasional behavioral change. A common variant, idiopathic intracranial hypertension, arises in otherwise healthy people, especially younger women, with no identifiable underlying cause, and in some presentations papilledema together with bilateral sixth cranial nerve palsies are the only clinical signs found on examination.