Idiopathic intracranial hypertension
Who gets IIH and who needs a harder look for another cause, triaging by vision rather than headache, acetazolamide and weight loss (IIHTT, IIH:WT), the emerging GLP-1 evidence, surgery for threatened sight, and the exam traps.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Raised intracranial pressure with normal brain imaging and normal CSF composition, and no cause found.
- Classically a woman of childbearing age with obesity. Incidence is about 1 to 2 per 100,000, rising to about 12 to 20 per 100,000 in women aged 15 to 44 with obesity.
- The threat is permanent visual loss. Headache causes most of the disability.
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Sources
- Therapeutic Guidelines: NeurologyAU/NZTherapeutic Guidelines Limited
- Idiopathic intracranial hypertension: consensus guidelines on management (Mollan SP et al. J Neurol Neurosurg Psychiatry 2018;89(10):1088-1100)Journal of Neurology, Neurosurgery and Psychiatry, 2018
- Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children (Friedman DI et al. Neurology 2013;81(13):1159-1165)Neurology, 2013
- Diagnosis, treatment and monitoring of idiopathic intracranial hypertension: consensus recommendations of the Austrian IIH network (Bsteh G et al. Cephalalgia 2025;45(11))Cephalalgia, 2025
- Effect of acetazolamide on visual function in patients with idiopathic intracranial hypertension and mild visual loss: the IIH Treatment Trial (JAMA 2014;311(16):1641-1651)NORDIC Idiopathic Intracranial Hypertension Study Group, JAMA, 2014
- Effectiveness of bariatric surgery vs community weight management intervention for idiopathic intracranial hypertension: IIH:WT (Mollan SP et al. JAMA Neurology 2021;78(6):678-686)JAMA Neurology, 2021
- The effect of GLP-1RA exenatide on idiopathic intracranial hypertension: IIH:Pressure trial (Mitchell JL et al. Brain 2023;146(5):1821-1830)Brain, 2023
- Use of GLP-1 receptor agonists in idiopathic intracranial hypertension: a systematic review (J Headache Pain 2025)Journal of Headache and Pain, 2025
- Last updated
- 14 November 2026
What changed
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