BENIGN INTRACRANIAL HYPERTENSION - ETIOLOGY, CLINICAL AND THERAPEUTIC ASPECTS

Introduction: BIH is a syndrome defined by increased intracranial pressure, normal CSF composition, absence of ventriculomegaly and intracranial lesion. Review of the literature reveals unknown etiology in majority of patients, various clinical symptoms and different treatment options. Objective: to study the etiology, clinical and therapeutic features in patients with BIH. Material and methods: Twelve patients with BIH, admitted to the hospital for the last 5 years were included in the study. The diagnosis was established on the basis of physical and neuro-ophthalmologic examinations, CT or MRI, and CSF evaluation. The major outcome criterion was the regression of papilledema. Results: All patients were young women. The most frequent clinical manifestations were transient visual obscurations, nausea, and headache. Neuro-ophthalmologic examination showed normal visual acuity, bilateral papilledema, enlarged blind spots, and bilateral abducent nerve paresis in two patients. Obesity, recent increase of weight and menstrual irregularities were potential risk factors. Papilledema resolved over the next 2-3 months after different treatments. In one patient three relapses were registered. Conclusion: Our own notes suggest that BIH most commonly associates with young age, female sex, and obesity. Neuro-ophthalmologic examination, neuroimaging, and CSF evaluation are the most useful diagnostic tools. The application of diuretics and corticosteroids most often provides a successful control over clinical symptoms and papilledema.