Intracranial Hypertension

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Intracranial hypertension, also known as pseudotumor cerebri, is a condition characterized by increased pressure within the skull. This condition can cause a range of symptoms, including headache, nausea, vomiting, pulsatile tinnitus, visual disturbances, papilledema, dizziness, neck pain, photophobia, and double vision. Understanding the causes, symptoms, and treatment options for intracranial hypertension is crucial for those affected by this condition.

Causes of Intracranial Hypertension

The exact cause of intracranial hypertension is often unknown, but several factors have been associated with its development. These include:

  • Obesity: Excess weight can increase the risk of developing intracranial hypertension.
  • Medications: Certain medications, such as tetracycline antibiotics and corticosteroids, have been linked to this condition.
  • Medical conditions: Conditions like sleep apnea, kidney disease, and hormonal disorders can contribute to intracranial hypertension.
  • Head injury: Trauma to the head can lead to increased pressure within the skull.

Symptoms of Intracranial Hypertension

Intracranial hypertension can present with various symptoms, which may vary in severity from person to person. Some common symptoms include:

  • Headache: Persistent and severe headaches are a hallmark symptom of intracranial hypertension. The pain is often described as throbbing or pulsating.
  • Nausea and vomiting: Many individuals with intracranial hypertension experience episodes of nausea and vomiting.
  • Pulsatile tinnitus: Some people may hear a rhythmic sound in their ears, often described as a pulsating or whooshing noise.
  • Visual disturbances: Blurred vision, double vision, and temporary vision loss can occur due to increased pressure on the optic nerves.
  • Papilledema: Swelling of the optic disc, which can be detected during an eye examination, is a common finding in intracranial hypertension.
  • Dizziness: Feeling lightheaded or dizzy is another symptom that can be associated with this condition.
  • Neck pain: Some individuals may experience neck pain or stiffness.
  • Photophobia: Sensitivity to light can occur, making it uncomfortable to be in bright environments.
  • Double vision: Seeing two images instead of one can be a result of increased pressure on the nerves controlling eye movement.

Diagnosis and Treatment


Diagnosing intracranial hypertension involves a combination of medical history evaluation, physical examination, and diagnostic tests. A healthcare professional may:

  • Ask about symptoms and their duration
  • Perform a thorough neurological examination
  • Order imaging tests, such as magnetic resonance imaging (MRI) or computed tomography (CT) scan, to rule out other causes of symptoms
  • Measure the pressure within the skull using a procedure called lumbar puncture or spinal tap
  • Conduct visual field testing to assess any vision loss


While there is no definitive cure for intracranial hypertension, several treatment options can help manage the condition and alleviate symptoms. These include:

  • Weight loss: Losing excess weight can significantly improve symptoms, especially in individuals who are overweight or obese.
  • Medications: Diuretics, such as acetazolamide, can help reduce the production of cerebrospinal fluid and lower intracranial pressure.
  • Shunting: In severe cases, a surgical procedure called a shunt may be necessary to divert excess cerebrospinal fluid away from the brain.
  • Optic nerve sheath fenestration: This surgical procedure involves creating a small opening in the optic nerve sheath to relieve pressure on the optic nerve.

It is important to note that treatment options may vary depending on the underlying cause of intracranial hypertension and the individual’s overall health.

Living with Intracranial Hypertension

Managing intracranial hypertension involves making certain lifestyle modifications to reduce symptoms and improve overall well-being. Here are some tips:

  • Follow a healthy diet: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support weight loss efforts and promote overall health.
  • Avoid triggers: Identify and avoid triggers that worsen symptoms, such as certain medications or activities that increase intracranial pressure.
  • Manage stress: Stress can exacerbate symptoms, so finding healthy ways to manage stress, such as practicing relaxation techniques or engaging in hobbies, is essential.
  • Regular exercise: Engaging in regular physical activity can help maintain a healthy weight and improve overall cardiovascular health.
  • Regular check-ups: Regular follow-up appointments with healthcare professionals are crucial to monitor symptoms, adjust treatment plans if necessary, and ensure overall well-being.

Living with intracranial hypertension can be challenging, but with proper management and support, individuals can lead fulfilling lives.


Intracranial hypertension is a condition characterized by increased pressure within the skull, leading to various symptoms such as headache, nausea, visual disturbances, and more. While the exact cause is often unknown, factors like obesity, certain medications, and medical conditions can contribute to its development. Diagnosis involves a combination of medical history evaluation, physical examination, and diagnostic tests. Although there is no definitive cure, lifestyle modifications, medications, and surgical interventions can help manage symptoms and improve quality of life. By following a healthy lifestyle and seeking appropriate medical care, individuals with intracranial hypertension can effectively manage their condition and minimize its impact on their daily lives.

Haroon Rashid, MD
Rate author
Urgent Care Center of Arlington, VA
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