Recognizing and Managing Idiopathic Intracranial Hypertension in the Emergency Department

Purpose of ReviewThis review covers evaluation and Emergency Department (ED) management of patients with symptoms consistent with idiopathic intracranial hypertension (IIH), along with reviewing new proposed mechanisms and treatments for the disease.Recent FindingsNew imaging techniques can provide evidence to support the clinical diagnosis of IIH, including MRI and bedside ultrasound. Recent studies suggest novel metabolic mechanisms and possible treatments for IIH.In the Emergency Department, clinicians should keep IIH on their differential in patients with headache and/or papilledema and work patients up to include or exclude other life threats as indicated. Treatment for IIH in the ED remains symptomatic, with most standard treatments unsupported by strong evidence. In patients with suspected or diagnosed IIH, knowing when to admit for consultation can improve patient outcomes and possibly spare their vision.