First 10EM - By Kristine Laing - November 16, 2020
..."IIH is a condition of raised intracranial pressure with no known cause. IIH was previously known as pseudotumor cerebri or benign intracranial hypertension. If left untreated, IIH may lead to permanent vision loss and/or chronic debilitating headaches...
When do we need to think about this in the ED?
IIH is commonly missed because it is rare and the symptoms are non-specific. Given the rise in cases each year, we must consider IIH, especially when a young, overweight female patient presents with any of the above signs/symptoms. The primary driver of further investigation is going to be the identification of papilledema, as papilledema is a major sign of raised intracranial pressure.
Bottom line for the ER
- If vision is impaired, stat referral to neurosurgery
- Treat headache with your usual medications
- Urgent referral to both Ophthalmology and Neurology
- Rule out life-threatening causes of papilloedema / raised ICP"