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