Benign Intracranial Hypertension

Benign intracranial hypertension is characterized by elevated intracranial pressure without an identifiable mass or hydrocephalus, often affecting obese women of childbearing age. Symptoms include headache, transient visual obscurations, pulsatile tinnitus, and papilledema. Pathophysiology is incompletely understood, with proposed mechanisms including impaired cerebrospinal fluid absorption or increased venous pressure. Diagnosis is based on neuroimaging to exclude secondary causes, lumbar puncture confirming elevated opening pressure, and ophthalmologic examination. Management includes weight reduction, acetazolamide or other diuretics, optic nerve sheath fenestration, or ventriculoperitoneal shunting; prognosis is favorable with prompt treatment to prevent permanent vision loss.