Document Detail

Medical and surgical management of idiopathic intracranial hypertension in pregnancy.
MedLine Citation:
PMID:  15324607     Owner:  NLM     Status:  MEDLINE    
Idiopathic intracranial hypertension (IIH) is a syndrome of increased intracranial pressure without hydrocephalus or mass lesion with elevated cerebrospinal fluid (CSF) pressure but otherwise normal CSF composition. It has been found that pregnancy occurs in IIH patients at about the same rate as in the general population, that IIH can occur in any trimester of pregnancy, that patients have the same spontaneous abortion rate as the general population, and that the visual outcome is the same as for nonpregnant patients with IIH. Although it is also stated that pregnant patients with IIH should be managed and treated the same way as any other patient with IIH, the use of imaging and drug contraindications do make a difference between the two groups. The treatment has two major goals, which are to preserve vision and to improve symptoms. The medical therapy includes weight control, nonketotic diet, serial lumbar punctures, diuretics, steroids, and certain analgesics. When medical therapy fails, surgical procedures should be considered. The two main procedures are optic nerve sheath fenestration and lumboperitoneal shunt. Anesthetic considerations in the pregnant patient are an additional factor when surgeries are contemplated. It is also noted that therapeutic abortion to limit progression of disease is not indicated and that subsequent pregnancies do not increase the risk of recurrence.
Rosa A Tang; E Ulysses Dorotheo; Jade S Schiffman; Hasan M Bahrani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current neurology and neuroscience reports     Volume:  4     ISSN:  1528-4042     ISO Abbreviation:  Curr Neurol Neurosci Rep     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-24     Completed Date:  2004-11-16     Revised Date:  2013-08-21    
Medline Journal Info:
Nlm Unique ID:  100931790     Medline TA:  Curr Neurol Neurosci Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  398-409     Citation Subset:  IM    
University of Texas Medical Branch, Galveston, Texas, 2476 Bolsover Street, Houston, TX 77005, USA.
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MeSH Terms
Anticonvulsants / therapeutic use
Antihypertensive Agents / therapeutic use
Diagnosis, Differential
Diuretics / therapeutic use
Fructose / analogs & derivatives*,  therapeutic use
Pregnancy Complications, Cardiovascular / drug therapy*,  pathology,  physiopathology,  surgery*
Propranolol / therapeutic use
Pseudotumor Cerebri / complications,  drug therapy*,  physiopathology,  surgery*
Spinal Puncture
Steroids / therapeutic use
Vision Disorders / etiology
Reg. No./Substance:
0/Anticonvulsants; 0/Antihypertensive Agents; 0/Diuretics; 0/Steroids; 0H73WJJ391/topiramate; 30237-26-4/Fructose; 525-66-6/Propranolol

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