Intracranial hypertension

Intracranial hypertension (IH) is a condition of increased pressure in the brain.

Signs and symptoms
The most common sign is papilledema.
 * Headache (worse when lying down)
 * Dizziness
 * Nausea / vomiting
 * Altered vision
 * Pulse sychronous tinnitus
 * Stiff neck
 * Back and arm pain
 * Pain behind the eyes
 * Photophobia
 * Exercise intolerance
 * Memory difficulties

Causes
Some causes of intracranial hypertension include: When the cause of increased pressure is unknown it is called idiopathic intracranial hypertension (IIH). It was previously known as pseudotumor cerebri, as the symptoms can mimic that of a brain tumor, even though no tumor is present. It is considered to be a rare disease, affecting just 1 in 100,000.
 * Venous stenosis
 * craniocervical instability
 * Chiari malformation
 * and many more

Treatment
Treatment approaches may depend on the cause and whether it can be identified. In idiopathic cases, treatments can include reducing spinal fluid volume, e.g., through drug treatments like Diamox or surgical treatments like a shunt.

Risk factors

 * Ehlers-Danlos syndrome

Related conditions
It has been observed by some clinicians that ME/CFS and Ehlers-Danlos syndrome patients may have borderline or subclinical intracranial hypertension and benefit from IIH treatments such as Diamox, venous stents, or shunts. While these treatments are rare in ME/CFS patients they are more commonly used in EDS patients.

ME/CFS
A case study of a woman presenting with symptoms of CFS and pressure headache, who was diagnosed with borderline intracranial hypertension, found that her CFS symptoms resolved with the placement of a transverse sinus stent. A cross-sectional study of twenty patients presenting at a headache clinic found that a large proportion of patients had borderline intracranial hypertension, with four meeting the diagnostic criteria for IIH (mean cerebrospinal fluid pressure was 19 cm H2O (range 12–41 cm H2O); however, none had clinical signs of IIH. Cerebrospinal fluid drainage via lumbar puncture improved symptoms in 17/20 patients. Researchers speculate that a subset of CFS patients may have borderline cases of idiopathic intracranial hypertension without papillodema, that is, swelling of the optic nerve.

Ehlers-Danlos syndrome
Penn State vascular neurosurgeon, Dr. Kenneth Liu, has presented case studies of patients with Ehlers-Danlos syndrome whose symptoms improve with venous stenting.

Notable studies

 * 2018, The link between idiopathic intracranial hypertension, fibromyalgia, and chronic fatigue syndrome: exploration of a shared pathophysiology - (Full text)

Learn more

 * Video: Venous Stenting in Intracranial Hypertension, Dr. Kenneth Liu