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Idiopathic Intracranial Hypertension — RACP Adult Medicine MCQ

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ModerateNeurologyIdiopathic Intracranial HypertensionRACP Adult Medicine

A 30-year-old obese woman presents with progressive headache worse on lying down, bilateral papilloedema, and pulsatile tinnitus. CT brain and MRV are normal. CSF opening pressure is 32 cmH₂O with normal composition. What is the most likely diagnosis?

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Correct answer: C — Idiopathic intracranial hypertension

Headache worse with recumbency, bilateral papilloedema, pulsatile tinnitus, and elevated CSF opening pressure (>25 cmH₂O) with normal CSF composition in an obese young woman is diagnostic of idiopathic intracranial hypertension. Treatment includes acetazolamide and weight loss. Optic nerve sheath fenestration may be needed for visual threat.

Reference: eTG Neurology – 2024 – Raised Intracranial Pressure