IIH, SIH and headache: Diagnosis and treatment update

Idiopathic intracranial hypertension (IIH) and spontaneous intracranial hypotension (SIH) are two major secondary headache disorders resulting from abnormal intracranial pressure (ICP). This short communication outlines the pathophysiology, diagnostic criteria, and management strategies for IIH and...

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Main Author: Shuu-Jiun Wang
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:eNeurologicalSci
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S240565022400039X
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author Shuu-Jiun Wang
author_facet Shuu-Jiun Wang
author_sort Shuu-Jiun Wang
collection DOAJ
description Idiopathic intracranial hypertension (IIH) and spontaneous intracranial hypotension (SIH) are two major secondary headache disorders resulting from abnormal intracranial pressure (ICP). This short communication outlines the pathophysiology, diagnostic criteria, and management strategies for IIH and SIH. IIH predominantly affects obese women of childbearing age and presents with daily headaches, visual disturbances, and papilledema. It is characterized by elevated cerebrospinal fluid (CSF) pressure, with diagnosis supported by imaging and lumbar puncture. Treatment includes weight reduction, medications, and surgical interventions in refractory cases. SIH, conversely, is caused by spontaneous spinal CSF leaks and presents with acute orthostatic headaches. Diagnosis is supported by neuroimaging and lumbar puncture, revealing low CSF pressure. Treatment includes supported care, (targeted) epidural blood patch, with surgical repair considered in refractory cases. Advances in imaging and treatment have significantly improved outcomes for both conditions.
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spelling doaj-art-79aef72053a04bbe97df0e6c75b701242025-08-20T02:31:47ZengElseviereNeurologicalSci2405-65022024-12-013710053210.1016/j.ensci.2024.100532IIH, SIH and headache: Diagnosis and treatment updateShuu-Jiun Wang0Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan; College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Corresponding author at: Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.Idiopathic intracranial hypertension (IIH) and spontaneous intracranial hypotension (SIH) are two major secondary headache disorders resulting from abnormal intracranial pressure (ICP). This short communication outlines the pathophysiology, diagnostic criteria, and management strategies for IIH and SIH. IIH predominantly affects obese women of childbearing age and presents with daily headaches, visual disturbances, and papilledema. It is characterized by elevated cerebrospinal fluid (CSF) pressure, with diagnosis supported by imaging and lumbar puncture. Treatment includes weight reduction, medications, and surgical interventions in refractory cases. SIH, conversely, is caused by spontaneous spinal CSF leaks and presents with acute orthostatic headaches. Diagnosis is supported by neuroimaging and lumbar puncture, revealing low CSF pressure. Treatment includes supported care, (targeted) epidural blood patch, with surgical repair considered in refractory cases. Advances in imaging and treatment have significantly improved outcomes for both conditions.http://www.sciencedirect.com/science/article/pii/S240565022400039XIdiopathic intracranial hypertensionSpontaneous intracranial hypotensionIntracranial pressureCerebrospinal fluidSecondary headache
spellingShingle Shuu-Jiun Wang
IIH, SIH and headache: Diagnosis and treatment update
eNeurologicalSci
Idiopathic intracranial hypertension
Spontaneous intracranial hypotension
Intracranial pressure
Cerebrospinal fluid
Secondary headache
title IIH, SIH and headache: Diagnosis and treatment update
title_full IIH, SIH and headache: Diagnosis and treatment update
title_fullStr IIH, SIH and headache: Diagnosis and treatment update
title_full_unstemmed IIH, SIH and headache: Diagnosis and treatment update
title_short IIH, SIH and headache: Diagnosis and treatment update
title_sort iih sih and headache diagnosis and treatment update
topic Idiopathic intracranial hypertension
Spontaneous intracranial hypotension
Intracranial pressure
Cerebrospinal fluid
Secondary headache
url http://www.sciencedirect.com/science/article/pii/S240565022400039X
work_keys_str_mv AT shuujiunwang iihsihandheadachediagnosisandtreatmentupdate