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World J Neurol. Mar 28, 2015; 5(1): 47-51
Published online Mar 28, 2015. doi: 10.5316/wjn.v5.i1.47
Resolution of idiopathic intracranial hypertension after sustained lowering of cerebrospinal fluid pressure
Peter C Gates
Peter C Gates, Deakin University, Neurology Department, Barwon Health, University Hospital, Geelong VIC 3220, Australia
Author contributions: Gates PC solely contributed to this manuscript.
Conflict-of-interest: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Peter C Gates, Professor, Deakin University, Neurology Department, Barwon Health, University Hospital, PO Box 281, Geelong VIC 3220, Australia. prof.petergates@gmail.com
Telephone: +61-3-42150711 Fax: +61-3-42150757
Received: September 21, 2014
Peer-review started: September 22, 2014
First decision: October 14, 2014
Revised: February 13, 2015
Accepted: March 5, 2015
Article in press: March 9, 2015
Published online: March 28, 2015
Processing time: 190 Days and 19.9 Hours
Abstract

Idiopathic intracranial hypertension (IIH) is a syndrome of headache due to raised intracranial pressure (ICP) where the cerebrospinal fluid (CSF) is normal and there is no alternative pathology on imaging. The aetiology is unknown. This review questions many of the prevailing views regarding aetiology and treatment of IIH. It explores the concept that there is a vicious cycle of fluctuating raised ICP leading to secondary compression of the transverse sinuses and further elevation of ICP. It also raises the question as to whether this vicious cycle could be relieved by prolonged drainage of CSF as seen in Lumbar puncture induced low-pressure headache or alternatively a lumbar drain.

Keywords: Lumbar puncture; Cerebrospinal fluid drainage; Idiopathic intracranial hypertension; Low-pressure headache

Core tip: Resolution of idiopathic intracranial hypertension can be achieved by prolonged cerebrospinal fluid drainage as seen with Lumbar puncture induced low-pressure headache.