Podcasts about idiopathic intracranial hypertension

Interview with Dennis J. Rivet II, MD, author of GLP-1 Receptor Agonists in Idiopathic Intracranial Hypertension. Hosted by Cynthia E. Armand, MD. Related Content: GLP-1 Receptor Agonists in Idiopathic Intracranial Hypertension

Idiopathic intracranial hypertension (IIH), a condition of increased intracranial pressure (ICP), causes debilitating headaches and, in some, visual loss. The visual defects are often in the periphery and not appreciated by the patient until advanced; therefore, monitoring visual function with serial examinations and visual fields is essential. In this episode, Kait Nevel, MD speaks with John J. Chen, MD, PhD, and Susan P. Mollan, MBChB, PhD, FRCOphth, authors of the article “Treatment and Monitoring of Idiopathic Intracranial Hypertension” in the Continuum® June 2025 Disorders of CSF Dynamics issue. Dr. Nevel is a Continuum® Audio interviewer and a neurologist and neuro-oncologist at Indiana University School of Medicine in Indianapolis, Indiana. Dr. Chen is a professor of ophthalmology and neurology at the Mayo Clinic in Rochester, Minnesota. Dr. Mollan is an honorary professor of metabolism and systems science in the department of neuro-ophthalmology at University Hospitals Birmingham in Birmingham, United Kingdom. Additional Resources Read the article: Treatment and Monitoring of Idiopathic Intracranial Hypertension Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @IUneurodocmom Guests: @chenmayo, @DrMollan Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Nevel: Hello, this is Dr Kate Nevel. Today, I'm interviewing Drs John Chen and Susan Mollan about their article on treatment and monitoring of idiopathic intracranial hypertension, which appears in the June 2025 Continuum issue on disorders of CSF dynamics. Drs Chen and Mollan, welcome to the podcast. And please, could you introduce yourselves to the audience? Dr Chen: Hello, everyone. I'm John Chen, one of the neuro-ophthalmologists at the Mayo Clinic. Thanks for having us here. Dr Mollan: Yeah, it's great to be with you here. I'm Susan Mollan. I'm a consultant neuro-ophthalmologist in Birmingham, England. Dr Nevel: Wonderful. So great to have you both here today, and our listeners. To start us off, talking about your article, can you share with us what you think is the most important takeaway from your article for the practicing neurologist out there? Dr Chen: Yeah, so our article talked about the treatment and monitoring of IIH. And I think one takeaway point is, IIH is becoming much more prevalent now that there's this worldwide obesity epidemic with obesity having- essentially being the largest risk factor for IIH other than female. It's really important to monitor vision because vision loss is often peripheral vision loss at first, which the patient may be completely unaware of. And so, it's important to pair up with an ophthalmologist so you can monitor the papilledema of the visual fields and make sure they don't get permanent vision loss. And in the article, we also talk about- there's been changes in the treatment of severe IIH, where traditionally, we used VP shunts; but there's been a trend toward using more venous sinus stenting in addition to the traditional surgeries. Dr Nevel: Great, thank you. I think probably most of our listeners or a lot of neurologists out there have a pretty good understanding of kind of the basics of the IIH. But can you kind of just go over a few key characteristics of IIH, and maybe some things that are less commonly known or things that are maybe just been kind of better understood over the past decade, perhaps? Dr Mollan: Yes, certainly. I think, as Dr Chen said, it's because this condition is becoming more prevalent, people recognize it. I think it's- we like to go back to the diagnostic criteria so that we're making a very accurate diagnosis. So, the patients may come in to the emergency room with, say, papilledema that's been identified elsewhere or crashing headaches. And it's important to go through that sort of diagnostic pathway, taking a blood pressure, taking a full blood count to make sure the patient is anemic, and then moving forward with that confirmation of papilledema into urgent neuroimaging, whether it's CT or MRI, but including venography to exclude a venous sinus thrombosis. And then if you have no structural lesion that's causing the raised ICP, it's moving forward with your lumbar puncture and carefully checking those pressures. But the patients may not only have crashing headache, they often have pulsatile tinnitus and neck pain. I think some of the features that we're now recognizing is the systemic metabolic effects that are unique to IIH. And so, there's an increased risk of cardiometabolic disease that's over and above what is conferred by obesity. Also, our patients have a sort of maternal health burden where they get impaired fertility, gestational diabetes and preeclampsia. And there's also an associated mental health burden, amongst other things. So we're really starting to understand the spectrum of the disease a bit more. Dr Nevel: Yeah, thank you for that. And that really struck me in your article, how important it is to be aware of those things so that we're making sure that we're managing our whole patient and connecting them with the appropriate providers for some of those other issues that may be associated. For the practicing neurologist out there without all the neuro-ophthalmology equipment, if you will, what should our bedside exam focus on to help us get maybe an early but accurate picture of the patient's visual function when we suspect IIH to be at play, perhaps before they can get in with the neuro-ophthalmologist? Dr Chen: Yeah, I think at the bedside you can still check visual acuity and confrontational visual fields, you know, with finger counting. Of course, you have to know that those are, kind of, crude kind of ways of screening. With papilledema, oftentimes the visual acuity is intact. And the confrontational visual fields aren't as sensitive as automated perimetry. Another important thing will be to do your direct ophthalmoscope and look at the amount of papilledema. If it's grade one or two papilledema on the more mild side, it's actually not vision threatening. It's the higher degrees of papilledema that can cause rapid vision loss. And so, if you look in and you see grade one papilledema, obviously you need to do the full workup, the MRI, MRV, lumbar puncture. But in terms of rapidly getting to an ophthalmologist to screen for vision loss, it's not going to be as important because you're not going to have vision loss at that low grade. If you look in and you see this rip-roaring papilledema, grade five papilledema, that patient is going to be at very severe risk of vision loss. So, I think that exam, looking at the optic nerve can be very helpful. And of course, talking to the patient about symptoms; is there decreased vision Is there double vision from a sixth nerve palsy? Are there transient visual obscurations which would indicate at least a higher degree of papilledema? That'd be helpful as well. Dr Nevel: Great, thank you. And when the patient does get in with a neuro-ophthalmologist, you talk in your article and, of course, in clinical practice, how OCT testing is important to monitor in this condition. Can you provide for the listeners the definition of OCT and how it plays a role in monitoring patients with IIH? Dr Mollan: Sure. So, OCT is short for optical coherence tomography imaging, and really the eye has been at the forefront of OCT alone. Our sort of cardiology colleagues are catching up on the imaging of blood vessels. But what it allows us to do is give us really good cross-sectional, anatomical-level changes that we can see both in the retina and also at the optic nerve head. And it gives us some really good measurements. It's not so good at sort of saying, is this definitely papilledema or not? That sort of lower end of disc elevation. But it is very good at ruling out what we call the pseudopapilledema. So, things like drusens or these other little masses we find underneath the optic nerve head. But in terms of monitoring, because we can longitudinally take these images and the reproducibility is pretty good at the optic nerve head, it allows us to see whether there's direct changes: either the papilledema getting worse or the papilledema getting better at the optic nerve head. It also gives us some indication of what's going on in the ganglion cell layer complex. And that can be helpful when we're thinking about sort of looking at structure versus function. So, ophthalmologists in general, we love OCT; and we spend much more time nowadays looking at the OCT than we really do the back of the eye. And it's just become critical for patients with papilledema to be able to be very accurate from visit to visit to see what's changing. Dr Nevel: How do you determine how frequently somebody needs to see the neuro-ophthalmologist with IIH and how often they need that OCT evaluation? Dr Chen: Once the diagnosis of IIH is made, how often they need to be seen and how frequent they need to be seen depends on the degree of papilledema. And again, OCT is really nice. You can quantify it and then different providers can actually use the same OCT numbers, which is super helpful. But again, if it's grade three papilledema or higher, or article thickness of 200 or higher, I tend to follow them a little bit more closely, trying to treat them more aggressively. Try to get the papilledema down into a safer zone. If it's grade one or two papilledema, we see them less frequently. So, my first visit might be three months out. They come with grade five papilledema, I'm seeing them within a few days to make sure that's papilledema's come down quickly because we're trying to decide, are they going to need surgery or not? Dr Nevel: Yeah, great. And that's a nice segue into talking a little bit about how we treat patients with IIH after the diagnosis is confirmed. And I'd like to just point out you have a very lovely figure in your article---Figure 5-6,---that I'd like to direct our listeners to read your article and check out that figure, which is kind of an algorithm on how we think about the various treatment options for patients who have IIH, which seems to rely a lot on the degree of presence of papilledema and the presence of vision disturbance. Could you maybe walk us through a little bit about how you think about the different treatment options for patients with IIH and when more urgent surgical intervention might be indicated? Dr Mollan: Yeah, sure. We always find it quite hard in any medical specialty to write these kind of flow diagrams because it's really an individual we're looking at. But these are kind of what we'd say is “broad brushstrokes” into those patients that we worry about, sort of, red disease in those patients, more amber disease. Now obviously, even those patients that may not have severe papilledema, they may have crashing headaches. So, they may be an urgent referral themselves because of that. And so, it's nice to try and work out which end of the spectrum you're working with. If we think of the papilledema, Dr Chen's already laid out the sort of lower end of the prison's scale---our grades one, our grades two---that we're less anxious about. And those patients, we would definitely be having discussions about medical management, which includes acetazolamide therapy; but also thinking about weight management. And it may well be that we talk a little bit further about weight management, but I think it's helpful to sort of coach those conversations after you've made a definite diagnosis. And then laying out the risk that's caused, potentially, the IIH in an individual. And then having a sort of open conversation with them about what changes they can have in their lifestyle alongside thinking about medical therapy. There's some patients with very low levels of papilledema that we decide not to put on medicines initially. As patients progress up that papilledema grade, we're definitely thinking about medical therapy. And our first line from the IIH treatment trial would be using acetazolamide, but we need to be thinking about using appropriate dosing. So, a lot of the patients that I see can be sent to me with very low doses that may be inappropriate for that person. In the IIHTT they used up to four grams daily in a divided dose. And you do need to counsel your patients when you're putting them on acetazolamide because of the side effects. You've got quite a nice table in this article about the side effects. I think if you get the patient on board, that they understand that they will experience side effects, that is helpful because they will expect it, and then possibly tolerate it a bit better. Moving through to that area where we're more anxious, that visual-threatening papilledema. As Dr Chen said, it's sort of like you look in and it's sort of “blood and thunder” in there. And you need to be getting on and encouraging the ophthalmologist to get a formal assessment of the visual field. It's very difficult to determine exactly the level at which- and we talk about the mean deviation in a lot of our research studies. But in general, it's a combination of things: the patient's journey to get to you, their symptoms, what's going on with the visual field, but what's also happening at the OCT. So, we look in and we see that fluid is seeping towards the fovea. We get very anxious, and those patients may not even have enough time for a rapid escalation of acetazolamide. It may well be at the first presentation, which we would term, like, fulminant; that we'd be thinking about surgical intervention. And I think before I stop, the other thing to say is, the surgical landscape is really changing. So, we're having some good studies coming out in terms of stenting. And so, there is a sort of bracket where it may well be that we are thinking about neuroradiological intervention in an earlier case. They may not quite be at that visual-threatening stage, but they may be resistant to medical treatments. Dr Nevel: Thank you for that. What do you think is a potential pitfall or a mistake to avoid, if you will, in the management of patients with IIH? Dr Chen: I think it's- in terms of pitfalls, I think the potential pitfalls I've seen are essentially patients where we don't necessarily create a good patient physician relationship. Where they don't have buy-ins on the treatment, they don't have buy-ins to come back, and they're lost to follow-up. And these patients can be dangerous, because they could have vision threatening papilledema and if not getting the appropriate treatment---and if they're not monitoring the vision---this can lead to poor outcomes. So, I've definitely seen that happen. As Dr Mollan said, you really have to tell them about the side effects from the medications. If you just take acetazolamide, letting them know the paresthesias and the changes in taste and some of these other side effects, they're going to immediately stop the medication. Again, and these medications do work, proven in the IIH treatment trial. So again, I think that patient-physician relationship is very important to make sure they have appropriate follow up. Dr Nevel: The topic of weight loss in this patient population can be tricky, and I know I talked with Susie in a prior interview about how to approach this topic with our patients in a sensitive and compassionate manner. Once this topic is broached, I find many patients are looking for advice on strategies for weight loss, or potentially medications or other interventions. How do you prioritize or think about the different weight loss strategies or treatments with your patients, and how do you think about the way that you recommend these different treatments or not? Dr Mollan: Yeah. I think that's a really great question because we sort of stray here into a specialty that we have not been trained in. One thing I definitely ask my patients: if they've been on a weight loss journey before, and what's worked for them and what's not worked for them. And within our different healthcare systems, we have access to different tiers of weight management approaches. But for the person sitting in front of me, that possibly there may be a long journey to access more professional care, it's about understanding. iIs there things that are free, such as, we have some apps in the National Health Service which are weight management applications where they can actually just start putting in their calories, their daily calorie intake. And those apps can be quite helpful and guiding in terms of targeting areas, but also informing the patient of what types of foods to avoid in their diet and what types of foods to include in their diet. And with some of the programs that are completely complementary, they also sometimes add on things about exercise. But I think it is a really difficult thing to manage as, say, an ophthalmologist or a neurologist, mainly because it's not our area of expertise. And I think we've all got to find, in our local hospitals and healthcare systems, those pathways where the patients may be able to access nutritional support, and sort of behavioral lifestyle therapy support, all the way through to the new medications for weight loss; and also for some people, bariatric surgery pathways. It's a tricky topic. Dr Nevel: So how should we counsel our patients about what to expect in the future in terms of visual outcomes? Dr Chen: I think a lot of that depends on the degree of papilledema when they present. If a patient comes in with grade five papilledema, that fulminant IIH that Dr Mollan had mentioned, these patients can have very severe vision loss. And even if we treat them very aggressively with high-dose medications and urgent surgical interventions, sometimes they can have permanent vision loss. And so, we counsel them that, you know, there's a strong chance that they're going to have a good amount of vision loss. But some patients, we're very surprised and we get a lot of vision back. So, we kind of set expectations, but we're cautiously optimistic that we can get vision back. If a patient presents with more mild papilledema like grade one or two papilledema, they're most likely not going to have any permanent vision loss as long as we're treating them, we're monitoring their vision, they're coming to their follow-ups. They tend to do very well from a vision perspective. Dr Nevel: That's great, thank you. And you know, ties into what you said earlier about really making sure that, you know, we create good- as with any patient, but good physician-patient relationships so that they, you know, trust us and they come to follow up so we can really monitor their vision appropriately. What do you think is going on in research in this area that's exciting? What do you think one of the next breakthroughs or thing that we need to understand the most about treatment and monitoring of IIH? Dr Chen: I think surgically, venous sinus stenting is going to probably take over the bulk of surgeries. We still need that randomized clinical trial, but we have some amazing outcomes with venous sinus stenting. And there's many efforts on randomized clinical trials for venous sinus stenting. So we'll have those results soon. From a medical standpoint, Dr Mollan can actually say, actually, more about this. Dr Mollan: I completely agree. The GLP-1 receptor agonists, the twofold prong approach: one is the weight loss where these patients, you know, have significant weight loss to put their disease into remission; and the other side of it is whether certain GLP-1s have the ability to reduce intracranial pressure. So, a phase 2 study that we undertook here in Birmingham did show that we were able to reduce intracranial pressure, but we don't think it's a class effect. So, I think the sort of big breakthrough will be looking at novel therapies like xenotide and other drugs that, say, work on the proximal kidney tubule. Are they able to reduce intracranial pressure directly? And I think we are on the cusp of a real breakthrough for this disease. Dr Nevel: Great. Thank you so much for chatting with me today. And I really learned a lot, appreciated the opportunity. I hope our listeners learned something today, too. So again, today I've been interviewing Drs John Chen and Susan Mollan about their article on treatment and monitoring of idiopathic intracranial hypertension, which appears in the most recent issue of Continuum on disorders of CSF dynamics. Be sure to check out Continuum Audio episodes from this and other issues. And thank you to our listeners for joining us today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Idiopathic intracranial hypertension (IIH) is characterized by symptoms and signs of unexplained elevated intracranial pressure (ICP) in an alert and awake patient. The condition has potentially devastating effects on vision, headache burden, increased cardiovascular disease risk, sleep disturbance, and depression.  In this episode, Teshamae Monteith, MD, FAAN speaks with Aileen A. Antonio, MD, FAAN, author of the article “Clinical Features and Diagnosis of Idiopathic Intracranial Hypertension” in the Continuum® June 2025 Disorders of CSF Dynamics issue. Dr. Monteith is the associate editor of Continuum® Audio and an associate professor of clinical neurology at the University of Miami Miller School of Medicine in Miami, Florida. Dr. Antonio is an associate program director of the Hauenstein Neurosciences Residency Program at Trinity Health Grand Rapids and an assistant clinical professor at the Michigan State University College of Osteopathic Medicine in Lansang, Michigan. Additional Resources Read the article: Clinical Features and Diagnosis of Idiopathic Intracranial Hypertension Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @headacheMD Guest: @aiee_antonio Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Monteith: Hi, this is Dr Teshamae Monteith. Today I'm interviewing Dr Aileen Antonio about her article on clinical features and diagnosis of idiopathic intracranial hypertension, which appears in the June 2025 Continuum issue on disorders of CSF dynamics.  Hi, how are you? Dr Antonio: Hi, good afternoon. Dr Monteith: Thank you for being on the podcast. Dr Antonio: Thank you for inviting me, and it's such an honor to write for the Continuum. Dr Monteith: So why don't you start off with introducing yourself? Dr Antonio: So as mentioned, I'm Aileen Antonio. I am a neuro-ophthalmologist, dually trained in both ophthalmology and neurology. I'm practicing in Grand Rapids, Michigan Trinity Health, and I'm also the associate program director for our neurology residency program. Dr Monteith: So, it sounds like the residents get a lot of neuro-ophthalmology by chance in your curriculum. Dr Antonio: For sure. They do get fed that a lot. Dr Monteith: So why don't you tell me what the objective of your article was? Dr Antonio: Yes. So idiopathic intracranial hypertension, or IIH, is a condition where there's increased intracranial pressure, but without an obvious cause. And with this article, we want our readers---and our listeners right now---to recognize that the typical symptoms and learning about the IIH diagnostic criteria are key to avoiding errors, overdiagnosis, or sometimes even misdiagnosis or underdiagnosis. Thus, we help make the most of our healthcare resources. Early diagnosis and management are crucial to prevent disability from intractable headaches or even vision loss, and it's also important to know when to refer the patients to the appropriate specialists early on. Dr Monteith: So, it sounds like your central points are really getting that diagnosis early and managing the patients and knowing how to triage patients to reduce morbidity and complications. Is that correct? Dr Antonio: That is correct and very succinct, yes. Dr Monteith: And so, are there any more recent advances in the diagnosis of IIH? Dr Antonio: Yes. And one of the tools that we've been using is what we call the optical coherence tomography. A lot of people, neurologists, physicians, PCP, ER doctors; how many among those physicians are well-versed in doing an eye exam, looking at the optic disc? And this is a great tool because it is noninvasive, it is high resolution imaging technique that allows us to look at the optic nerve without even dilating the eye. And we can measure that retinal nerve fiber layer, or RNFL; and that helps us quantify the swelling that is visible or inherent in that optic nerve. And we can even follow that and monitor that over time. So, this gives us another way of looking at their vision and getting that insight as to how healthy is their vision still, along with the other formal visual tests that we do, including perimetry or visual field testing. And then all of these help in catching potentially early changes, early worsening, that may happen; and then we can intervene more easily. Dr Monteith: Great. So, it sounds like there's a lot of benefits to this newer technology for our patients. Dr Antonio: That is correct. Dr Monteith: So, I read in the article about the increased incidence of IIH, and I have to say that I completely agree with you because I'm seeing so much of it in my clinic, even as a headache specialist. And I had a talk with a colleague who said that the incidence of SIH and IIH are similar. And I was like, there's no way. Because I see, I can see several people with IIH just in one day. That's not uncommon. So, tell me what your thoughts are on the incidence, the rising incidence of IIH; and we understand that it's the condition associated with obesity, but it sounds like you have some other underlying drivers of this problem. Dr Antonio: Yes, that is correct. So, as you mentioned, IIH tends to affect women of childbearing age with obesity. And it's interesting because as you've seen that trend, we see more of these IIH cases recently, which seem to correlate with that rising rate of obesity. And the other thing, too, is that this trend can readily add to the burden of managing IIH, because not only are we dealing with the headaches or the potential loss of vision, but also it adds to the burden of healthcare costs because of the other potential comorbidities that may come with it, like cardiovascular risk factors, PCOS, and sleep apnea. Dr Monteith: So why don't we just talk about the diagnosis of IIH? Dr Antonio: IIH, idiopathic intracranial hypertension, is also called pseudotumor cerebri.  It's essentially a condition where a person experiences increased intracranial pressure, but without any obvious cause. And the tricky part is that the patients, they're usually fully awake and alert. So, there's no obvious tumor, brain tumor or injury that causes the increased ICP. It's really, really important to rule out other conditions that might cause these similar symptoms; again, like brain tumors or even the cerebral venous sinus thrombosis. Many patients will have headaches or visual disturbances like transient visual obscurations---we call them TVOs---or double vision or diplopia. The diplopia is usually related to a sixth nerve palsy or an abducens palsy. Some may also experience some back pain or what we call pulsatile tinnitus, which is that pulse synchronous ringing in their ears. The biggest sign that we see in the clinic would be that papilledema; and papilledema is a term that we only use, specifically use, for those optic nerve edema changes that is only associated with increased intracranial pressure. So, performing of endoscopy and good eye exam is crucial in these patients. We usually use the modified Dandy criteria to diagnose IIH. And again, I cannot emphasize too much that it's really important to rule out other secondary causes to that increased intracranial pressure. So, after that thorough neurologic and eye evaluation with neuroimaging, we do a lumbar puncture to measure the opening pressure and to analyze the cerebrospinal fluid. Dr Monteith: One thing I learned from your article, really just kind of seeing all of the symptoms that you mentioned, the radicular pain, but also- and I think I've seen some papers on this, the cognitive dysfunction associated with IIH. So, it's a broader symptom complex I think than people realize. Dr Antonio: That is correct. Dr Monteith: So, you mentioned TVOs. Tell me, you know, if I was a patient, how would you try and elicit that from me? Dr Antonio: So, I would usually just ask the patient, while you're sitting down just watching TV---some of my patients are even driving as this happens---they would suddenly have these episodes of blacking out of vision, graying out of vision, vision loss, or blurred vision that would just happen, from seconds to less than a minute, usually. And they can happen in one eye or the other eye or both eyes, and even multiple times a day. I had a patient, it was happening 50 times a day for her. It's important to note that there is no pain associated with it most of the time. The other thing too is that it's different from the aura that patients with migraines would have, because those auras are usually scintillating and would have what we call the positive phenomena: the flashing lights, the iridescence, and even the fortification that they see in their vision. So definitely TVOs are not the migraine auras. Sometimes the TVOs can also be triggered by sudden changes in head positions or even a change in posture, like standing up quickly. The difference, though, between that and, like, the graying out of vision or the tunneling vision associated with orthostatic hypotension, is that the orthostatic hypotension would also have that feeling of lightheadedness and dizziness that would come with it. Dr Monteith: Great. So, if someone feels lightheaded, less likely to be a TVO if they're bending down and they have that grain of vision. Dr Antonio: That is correct. Dr Monteith: Definitely see patients like that in clinic. And if they have fluoride IIH, I'm like, I'll call it a TVO; if they don't, I'm like, it's probably more likely to be dizziness-related. And then we also have patient migraines that have blurriness that's nonspecific, not necessarily associated with aura. But I think in those patients, it's usually not seconds long, it's usually probably longer episodes of blurriness. Would you agree there, or…? Dr Antonio: I would agree there, and usually the visual aura would precede the headache that is very characteristic of their migraine, very stereotypical for their migraines. And then it would dissipate slowly over time as well. With TVOs, they're brisk and would not last, usually, more than a minute. Dr Monteith: So, why don't we talk about routine imaging? Obviously, ordering an MRI, and I read also getting an MRV is important. Dr Antonio: It is very important because, one: I would say IIH is also a diagnosis of exclusion. We need to make sure that the increased ICP is not because of a brain tumor or not because of cerebral venous sinus thrombosis. So, it's important to get the MRI of the brain as well as the MRV of the head. Dr Monteith: Do you do that for all patients' MRV, and how often do you add on an orbital study? Dr Antonio: I usually do not add on an orbital study because it's not really going to change my management at that point. I really get that MRI of the brain. Now the MRV, for most of my patients, I would order it already just because the population that I see, I don't want to lose them. And sometimes it's that follow-up, and that is the difficult part; and it's an easy add on to the study that I'm going to order. Again, it depends with the patient population that you have as well, and of course the other symptoms that may come with it. Dr Monteith: So, why don't we talk a little bit about CSF reading and how these set values, because we get people that have readings of 250 millimeters of water quite frequently and very nonspecific, questionable IIH. And so, talk to me about the set value. Dr Antonio: Right. So, the modified Dandy criteria has shown that, again, we consider intracranial pressure to be elevated for adults if it's above 250 millimeters water; and then for kids if it's above 280 millimeters of water. Knowing that these are taken in the left lateral decubitus position, and assuming also that the patients were awake and not sedated during the measurement of the CSF pressure. The important thing to know about that is, sometimes when we get LPs under fluoroscopy or under sedation, then these can cause false elevation because of the hypercapnia that elevated carbon dioxide, and then the hypoventilation that happens when a patient is under sedation. Dr Monteith: You know, sometimes you see people with opening pressures a little bit higher than 25 and they're asymptomatic. Well, the problem with these opening pressure values is that they can vary somewhat even across the day. People around 25, you can be normal, have no symptoms, and have opening pressure around 25- or 250; and so, I'm just asking about your approach to the CSF values. Dr Antonio: So again, at the end of the day, what's important is putting everything together. It's the gestalt of how we look at the patient. I actually had an attending tell me that there is no patient that read the medical textbook. So, the, the important thing, again, is putting everything together. And what I've also seen is that some patients would tell me, oh, I had an opening pressure of 50. Does that mean I'm in a dire situation? And they're so worried and they just attach to numbers. And for me, what's important would be, what are your symptoms? Is your headache, right, really bad, intractable? Number two: are you losing vision, or are you at that cusp where your optic nerve swelling or papilledema is so severe that it may soon lead to vision loss? So, putting all of these together and then getting the neuroimaging, getting the LP. I tell my residents it's like icing on the cake. We know already what we're dealing with, but then when we get that confirmation of that number… and sometimes it's borderline, but this is the art of neurology. This is the art of medicine and putting everything together and making sure that we care and manage it accordingly. Dr Monteith: Let's talk a little bit about IIH without papilledema. Dr Antonio: So, let's backtrack. So, when a patient will fit most of the modified Dandy criteria for IIH, but they don't have the papilledema or they don't have abducens palsy, the diagnosis then becomes tricky. And in these kinds of cases, Dr Friedman and her colleagues, when they did research on this, suggested that we might consider the diagnosis of IIH. And she calls this idiopathic intracranial hypertension without papilledema, IIHWOP. They say that if they meet the other criteria for modified Dandy but show at least three typical findings on MRI---so that flattening of the posterior globe, the tortuosity of the optic nerves, the empty sella or the partially empty sella, and even the narrowing of the transverse venous sinuses---so if you have three of these, then potentially you can call these cases as idiopathic intracranial hypertension without papilledema. Dr Monteith: Plus, the opening pressure elevation. I think that's key, right? Getting that as well. Dr Antonio: Yes. Sometimes IIHWOP may still be a gray area. It's a debate even among neuro-ophthalmologists, and I bet even among the headache specialists. Dr Monteith: Well, I know that I've had some of these conversations, and it's clear that people think this is very much overdiagnosed. So, that's why I wanted to plug in the LP with that as well. Dr Antonio: Right. And again, we have not seen yet whether is, this a spectrum, right? Of that same disease just manifesting differently, or are they just sharing a same pathway and then diverging? But what I want to emphasize also is that the treatment trials that we've had for IIH do not include IIHWOP patients. Dr Monteith: That is an important one. So why don't you wrap this up and tell our listeners what you want them to know? Now's the time. Dr Antonio: So, the- again, with IIH, with idiopathic intracranial hypertension, what is important is that we diagnose these patients early. And I think that some of the issues that come into play in dealing with these patients with IIH is that, one: we may have anchoring bias. Just because we see a female with obesity, of reproductive age, with intractable headaches, it does not always mean that what we're dealing with is IIH. The other thing, too, is that your tools are already available to you in your clinic in diagnosing IIH, short of the opening pressure when you get the lumbar puncture. And I need to emphasize the importance of doing your own fundoscopy and looking for that papilledema in these patients who present to you with intractable headaches or abducens palsy. What I want people to remember is that idiopathic intracranial hypertension is not optic nerve sheath distension. So, these are the stuff that you see on neuroimaging incidentally, not because you sent them, because they have papilledema, or because they have new headaches and other symptoms like that. And the important thing is doing your exam and looking at your patients. Dr Monteith: Today, I've been interviewing Dr Aileen Antonio about her article on clinical features and diagnosis of idiopathic intracranial hypertension, which appears in the most recent issue of Continuum on disorders of CSF dynamics. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today. Thank you again. Dr Antonio: Thank you. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

The "River" stent is a novel stent designed specifically to account for the anatomical and procedural requirements of venous sinus stenosis. A multicentre study of the device's safety and efficacy is underway, comprising 39 subjects across 5 US centres. The 1-year results have been recently published in JNIS. Editor-in-Chief of JNIS, Dr. Felipe C. Albuquerque, interviews Dr. Athos Patsalides¹, author of the paper: The River study: the first prospective multicenter trial of a novel venous sinus stent for the treatment of idiopathic intracranial hypertension 1. Department of Neurological Surgery, North Shore University Hospital, Manhasset, New York, USA   Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

In this episode, we review the high-yield topic⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Idiopathic Intracranial Hypertension (Pseudotumor Cerebri)⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠from the Neurology section at ⁠⁠⁠⁠⁠⁠Medbullets.com⁠⁠⁠⁠⁠⁠Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets

You can't control your health any more than you can control the weather. In this episode, I explore how holding individuals responsibe for their health is a relatively recent phenomenon tied to capitalism and neoliberalism, contrasting it with historical perspectives where health was viewed as a collective responsibility. I talk about the benefits of moving from body control to body trust, while addressing systemic factors affecting health and the importance of building supportive communities. Key moments:The Control Illusion [1:31] The Historical Perspective [11:17] What Actually Shapes Our Health? [15:53] Reframing Health as Collective [19:39] Moving from Control to Trust [23:40] Everything You've Been Taught About Weight Loss is a Lie [28:49] Q&A on Idiopathic Intracranial Hypertension (36:25)Learn more about my Free Course "Redefining Health"Join The Weighting Room before the 19th February and get a free 30 minute chronic pain consultationThis week's paper is  Tomiyama, A. Janet, Britt Ahlstrom, and Traci Mann. "Long-term Effects of Dieting: Is Weight Loss Related to Health?" Social and Personality Psychology Compass, vol. 7, no. 12, 2013, pp. 861-877. Wiley Online Library, https://doi.org/10.1111/spc3.12076. Visit Asher's website and check out all his FREE RESOURCES. You can also book a consultation, join a course, find out about upcoming events, or join their exclusive online community The Weighting Room. If you enjoy this podcast and would like to support Asher so that he can continue making them, you can become a Patron. You'll find Asher on all the usual social media channels including Instagram, YouTube and Tik Tok.

No episódio de hoje recebemos Dr. Eduardo Jorge que é Médico neuropediatra, Doutor em Saúde da Criança pela Fiocruz e especialista em saúde digital e neurofisiologia. Conversamos sobre sintomas e sinais de alerta nas cefaléias, definição e classificação da hipertensão intracraniana idiopática (HII), medicamentos e doenças sitêmicas associadas à HICC, quais exames solicitar, achados nos exames de imagem, tratamento e acompanhamento desses pacientes.MATERIAL SUPLEMENTARLinks:https://eyewiki.org/Pseudotumor_Cerebri_(Idiopathic_Intracranial_Hypertension)https://eyewiki.org/Papilledema#Disc_Appearancehttps://radiopaedia.org/articles/idiopathic-intracranial-hypertension-1?lang=usIOVS 2009 Follow-up of Mild Papilledema in Idiopathic Intracranial Hypertension with Optical Coherence TomographyGema Rebolleda (https://iovs.arvojournals.org/article.aspx?articleid=2164818)

افزایش فشار ایدیوپاتیک‌ مغری

Living with Idiopathic intracranial hypertension isn't easy. No one tells you the ups and downs you go through with this illness. It's so difficult to describe because it affects each person differently.

Welcome, listeners, to another intriguing episode of DITCH THE LAB COAT. I'm your host, Dr. Mark, and today we've got a particularly compelling show that delves deep into the complexities of obesity medicine. In episode four, we're honored to have obesity and type two diabetes expert, Dr. Sean Wharton, join us to unravel the mysteries of this fascinating and often misunderstood field. Dr. Sean Wharton, Specialist in General Internal Medicine will shed light on how obesity, a disease mired in stigma and misconception, impacts much more than one's physical appearance—it intertwines with psychological states and numerous other medical conditions ranging from cognitive disorders to cardiovascular diseases.Prepare to challenge what you thought you knew about weight management as we discuss the genetic components of obesity, the effectiveness of medications, and the societal perceptions that shape our response to this modern epidemic. This isn't just about the numbers on a scale; it's about understanding the human element behind the struggle with weight, the unseen battles with societal expectations, and the cutting-edge medical interventions that are reshaping lives.Now, let's strip away the stereotypes and biases as Dr. Sean Wharton guides us through the medical and psychological impacts of obesity, the latest research on genetic predispositions, and the innovative treatments leading the charge against this chronic condition. Are you ready to ditch the lab coat and dive into the heart of the matter? Let's get started.00:00 General internist explaining role as non-surgical doctor.04:57 Listen to people with obesity, avoid defining.06:21 Obesity's medical and psychological impacts on health.10:33 Obesity connected to health issues, including diabetes.13:26 Smoking and cancer risk linked to environment.17:01 Genetic predisposition to preserve fat in modern society.21:01 Understanding thinness: a genetic puzzle unsolved.26:16 David Allison criticized calorie signboards, lost job.28:55 Obesity driven by genetic desire for calories.30:53 Compassion and understanding key in treating genetics.35:26 Redundant system for weight regain hormonal response.38:17 Developing super pill with glp one mixture.40:40 Medications may increase risk of pancreatic cancer.45:36 Access to medical treatment affects obesity in Canada.49:50 Parenting challenges, obesity, and societal attitudes addressed.

This week's episode is with Levi Peterson, a fighter of Idiopathic Intracranial Hypertension, Neuro-Behçet's syndrome, and Parksinon's disease. Levi has also experienced 10 major brain surgeries, resulting in her becoming an expert on shunting technology from past complications. In the past, she was an EMT, and currently, she is a patient navigator, which we expand on in the episode.In addition, Levi shares ways she maintained hope and remained strong through her 10 brain surgeries and how she is using her experiences to help other patients currently. We also talk about the numerous complications Levi endured after her invasive surgeries and how artificial intelligence could play a role in the future of shunts. We later discuss the stigma behind IIH and how new research and technology are playing a role in reducing this stigma and increasing awareness of rare neurological disorders. Levi's bravery and strength are incredible, and her humor makes this episode an entertaining listen! Make sure to subscribe to the Neurological Disorder Podcast on Spotify, Apple Podcasts, or wherever you listen to your podcasts! Follow me on Instagram- @neurologicaldisorderpodcast Email me - neurologicaldisorderpodcast@gmail.comLinks Levi Mentioned/helpful resources:https://rarediseases.org/https://my.clevelandclinic.org/health/diseases/21968-idiopathic-intracranial-hypertensionhttps://www.mayoclinic.org/diseases-conditions/behcets-disease/symptoms-causes/syc-20351326

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: July 18, 2017 Idiopathic intracranial hypertension, also known as the pseudotumor cerebri syndrome, is characterized by elevated intracranial pressure with clinical features of headaches, vision impairment, and occasionally cranial nerve palsies in the absence of a structural lesion on neuroimaging. But that doesn't mean the neuroimaging has to be normal. See what Dr. Anita Kohli has to say about the radiographic correlates of idiopathic intracranial hypertension, their relevance, and their prognostic utility in this week's episode. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. REFERENCES Agid R, Farb RI, Willinsky RA, Mikulis DJ, Tomlinson G. Idiopathic intracranial hypertension: the validity of cross-sectional neuroimaging signs. Neuroradiology 2006;48(8):521-7. PMID 16703359Bidot S, Bruce BB. Update on the diagnosis and treatment of idiopathic intracranial hypertension. Semin Neurol 2015;35(5):527-38. PMID 26444398Bidot S, Clough L, Saindane AM, Newman NJ, Biousse V, Bruce BB. The optic canal size is associated with the severity of papilledema and poor visual function in idiopathic intracranial hypertension. J Neuroophthalmol 2016;36(2):120-5. PMID 26580295Bidot S, Saindane AM, Peragallo JH, Bruce BB, Newman NJ, Biousse V. Brain imaging in idiopathic intracranial hypertension. J Neuroophthalmol 2015;35(4):400-11. PMID 26457687Friedman DI, Liu GT, Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology 2013;81(13):1159-65. PMID 23966248Zagardo MT, Cail WS, Kelman SE, Rothman MI. Reversible empty sella in idiopathic intracranial hypertension: an indicator of successful therapy? AJNR Am J Neuroradiol 1996;17(10):1953-6. PMID 8933886  We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

It's YOUR time to access information that #BendyBodies need, crave, and deserve. Medical insights, science-based information, inspiring stories, empathy and support, hypermobility hacks, and news you can use. In this episode, YOUR guest is neurosurgeon, Paolo Bolognese, MD, founder of the Chiari Neurosurgical Center in New York.  Dr. Bolognese is also on the Board of Directors of the American Syringomyelia & Chiari Alliance Project, Inc. (ASAP), on the Scientific Education and Advisory Board of the Chiari Syringomyelia Foundation (CSF), and is a member of the International Consortium on EDS, HSD, and Related Disorders. The Chiari EDS Center is focused on the diagnosis and treatment of Chiari I Malformation, Syringomyelia, Craniocervical Instability, Tethered Cord, Eagle Syndrome, Idiopathic Intracranial Hypertension, and Intracranial Hypotension.  Dr Bolognese's surgical experience includes more than 1,600 Chiari Decompressions and 900 Craniocervical Fusions, 300 of which with condylar screws.  He is on the Board of the main national and international organizations focused on Chiari and Syringomyelia and has also made contributions in the field of Intraoperative Ultrasound and Laser Doppler Flowmetry.YOUR guest co-host is Pradeep Chopra, MD, Harvard-trained anesthesiologist double Board Certified in Pain Management and Anesthesiology, Director of the Center for Complex Conditions and Assistant Professor, Brown Medical School with a special interest in chronic complex pain conditions and their associated co-existing conditions. YOUR host, as always, is Dr. Linda Bluestein, the Hypermobility MD. Explored in this episode:·   How Dr Bolognese discovered the link between Ehlers-Danlos Syndromes (EDS) and Chiari I malformation ·   Why people with EDS are at increased risk of craniocervical instability·   What type of imaging he prefers for the evaluation of Chiari I malformation and/or cervical instability ·   Why he started performing surgery for Eagle's Syndrome ·   Why he feels invasive cervical traction is an essential part of the neurosurgical evaluation for upper cervical spine problems·   Causes of elevated intracranial pressure This episode is really special as it is rare to get a neurosurgeon's point of view outside of a medical appointment.  It may be easier for you to have the transcript in front of you while you are watching this episode of the Bendy Bodies Podcast on our YouTube channel or listening to this episode on your favorite podcast player.  Dr. Bolognese uses his hands a lot for demonstration so you may find watching this episode on YouTube beneficial.This important conversation about neurosurgical problems will leave you feeling hopeful, prepared to tackle that next step, with a better understanding of the multitude of factors that can impact symptoms.  Connect with YOUR Bendy Specialist, Linda Bluestein, MD! Thank YOU so much for tuning in. We hope you found this episode informative, inspiring, useful, validating, and enjoyable. Join us on the next episode for YOUR time to level up your knowledge about hypermobility disorders and the people who have them. Join YOUR Bendy Bodies community at www.BendyBodiesPodcast.com. YOUR bendy body is our highest priority!Products, organizations, and services mentioned in this episode:https://chiariedscenter.com/ #Hypermobility #EDSpodcast #JawPain #TMD #TMJ #HypermobilityPodcast #HypermobilityMD #BendyBuddy  #ChronicIllness #ChronicPain #InvisibleIllness #HypermobileHacks #EhlersDanlosSyndrome #PainManagementJourney #PhysicalTherapy #EDSdoctor

In this episode, YOUR guest is neurosurgeon, Paolo Bolognese, MD, founder of the Chiari Neurosurgical Center in New York.  Dr. Bolognese is also on the Board of Directors of the American Syringomyelia & Chiari Alliance Project, Inc. (ASAP), on the Scientific Education and Advisory Board of the Chiari Syringomyelia Foundation (CSF), and is a member of the International Consortium on EDS, HSD, and Related Disorders. The Chiari EDS Center is focused on the diagnosis and treatment of Chiari I Malformation, Syringomyelia, Craniocervical Instability, Tethered Cord, Eagle Syndrome, Idiopathic Intracranial Hypertension, and Intracranial Hypotension.  Dr Bolognese's surgical experience includes more than 1,600 Chiari Decompressions and 900 Craniocervical Fusions, 300 of which with condylar screws.  He is on the Board of the main national and international organizations focused on Chiari and Syringomyelia and has also made contributions in the field of Intraoperative Ultrasound and Laser Doppler Flowmetry.YOUR guest co-host is Pradeep Chopra, MD, Harvard-trained anesthesiologist double Board Certified in Pain Management and Anesthesiology, Director of the Center for Complex Conditions and Assistant Professor, Brown Medical School with a special interest in chronic complex pain conditions and their associated co-existing conditions. YOUR host, as always, is Dr. Linda Bluestein, the Hypermobility MD. Explored in this episode:·   How Dr Bolognese discovered the link between Ehlers-Danlos Syndromes (EDS) and Chiari I malformation ·   Why people with EDS are at increased risk of craniocervical instability·   What type of imaging he prefers for the evaluation of Chiari I malformation and/or cervical instability ·   Why he started performing surgery for Eagle's Syndrome ·   Why he feels invasive cervical traction is an essential part of the neurosurgical evaluation for upper cervical spine problems·   Causes of elevated intracranial pressure This episode is really special as it is rare to get a neurosurgeon's point of view outside of a medical appointment.  It may be easier for you to have the transcript in front of you while you are watching this episode of the Bendy Bodies Podcast on our YouTube channel or listening to this episode on your favorite podcast player.  Dr. Bolognese uses his hands a lot for demonstration so you may find watching this episode on YouTube beneficial.This important conversation about neurosurgical problems will leave you feeling hopeful, prepared to tackle that next step, with a better understanding of the multitude of factors that can impact symptoms.  Connect with YOUR Bendy Specialist, Linda Bluestein, MD! Thank YOU so much for tuning in. We hope you found this episode informative, inspiring, useful, validating, and enjoyable. Join us on the next episode for YOUR time to level up your knowledge about hypermobility disorders and the people who have them. Join YOUR Bendy Bodies community at https://www.bendybodiespodcast.com/.       YOUR bendy body is our highest priority!Products, organizations, and services mentioned in this episode:https://chiariedscenter.com/Access Dr. Bolognese's intake forms here.https://www.dropbox.com/scl/fo/2vrapu5w2b0ara2pyke8l/h?rlkey=06e9q7pjhwhyypo0xjhn0jkgy&dl=0 #Hypermobility #EDSpodcast #JawPain #TMD #TMJ #HypermobilityPodcast #HypermobilityMD #BendyBuddy  #ChronicIllness #ChronicPain #InvisibleIllness #HypermobileHacks #EhlersDanlosSyndrome #PainManagementJourney #PhysicalTherapy #EDSdoctor

In this podcast, JNIS Editor-in-Chief, Dr. Felipe C. Albuquerque, speaks with Dr. Michael Levitt (1) and Dr. Colin Derdeyn (2), authors of a pair of editorials discussing the practice of dural venous sinus stenting for patients with idiopathic intracranial hypertension.   Point: Dural venous sinus stenting should be considered a first-line treatment option for select patients with idiopathic intracranial hypertension https://jnis.bmj.com/content/early/2023/06/20/jnis-2023-020597  Counterpoint: stenting for idiopathic intracranial hypertension should be trialed https://jnis.bmj.com/content/early/2023/06/20/jnis-2023-020404    These articles are free-to-access for a month following the publication of this podcast.    Please subscribe to the JNIS Podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest episodes. Also, please consider leaving us a review or a comment on the JNIS Podcast iTunes page: https://podcasts.apple.com/gb/podcast/jnis-podcast/id942473767  Thank you for listening! This episode was edited by Brian O'Toole.    (1) Neurological Surgery, University of Washington School of Medicine, Seattle, Washington, USA (2) Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA

This week Mary and Alex discuss the reasons for and the process through which we might go about seeking a 2nd opinion. 1. To gather information, 2. Not comfortable with diagnosis, 3. Unsuccessful treatment #Podcast #Spotify #Anchor #research #advocacy #pectusexcavatum #IdiopathicIntracranialHypertension #discectomy #2nd opinion Stay Connected  Email Us: downthereaware@gmail.com Instagram:@downthereaware  Facebook: Down There Aware  Twitter: @downthereaware Pinterest: Down There Aware TikTok: Down There Aware Episode Links The Gift of Fear: And Other Survival Signals That Protect Us from Violence Pectus excavatum: Not just a cosmetic concern Idiopathic Intracranial Hypertension: Symptoms, Causes & Treatment Episode Highlights Intro [0:13] Welcome Back! [1:24] Happy Birthday, Mary & George! [1:48] Second opinions [2:20] Negative stigma? [2:58] Gathering more information [3:31] Will's 2nd opinion for pectus excavatum [4:31] Alex's 2nd opinion for IIH [7:13] The Gift of Fear [12:04] Treatment is unsuccessful [16:35] Didn't seek 2nd opinion [17:10] Back injury [18:28] No need to rush into decisions [23:31] Sadie may enters [26:07] Thanks for listening! [26:15] Summary Keywords  Podcast, Spotify, Anchor, research, advocacy, pectus excavatum, Idiopathic Intracranial Hypertension, discectomy, 2nd opinion --- Send in a voice message: https://podcasters.spotify.com/pod/show/downthereaware/message

Kari talks about her experience being diagnosed with a brain aneurysm and Idiopathic Intracranial Hypertension, navigating the healthcare system, and how it's impacted her life.

Dr. Alexandra Jean Sinclair discusses her paper, "Disease Course and Long-term Outcomes in Pregnant Women With Idiopathic Intracranial Hypertension". Show references: https://n.neurology.org/content/100/15/e1598

In this episode, Dr. Roy Baskind and Dr. Ahmit Shah answer such questions as: when is an opening pressure on LP required? When should we pull the trigger on ordering a CT venogram in the patient with unexplained headache? Which older patients who present with headache require an ESR/CRP? How do the presentations of cerebral venous thrombosis (CVT) and idiopathic intracranial hypertension (IIH) compare and contrast? When is it safe to start steroids in the ED for patients suspected of giant cell arteritis (GCA); will starting steroids affect the accuracy of a temporal artery biopsy? How soon should patients suspected of GCA get a temporal artery biopsy? When should we consider posterior reversible encephalopathy syndrome (PRES) and pituitary apoplexy in the peripartum patient? How should we think about the differential diagnosis of vascular headaches? and many more...  The post Ep181 Cerebral Venous Thrombosis, Idiopathic Intracranial Hypertension, Giant Cell Arteritis and Peripartum Headaches appeared first on Emergency Medicine Cases.

Michelle is unsure when her journey with idiopathic intracranial hypertension (IIH) began. She started experiencing chronic migraines and pulsatile tinnitus in her 20s, which may have been the first sign. However, a freak accident in which a man fell from a theater balcony onto Michelle in 2017 intensified her symptoms, […]

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.Originally released: July 9, 2020Webster defines “idiopathic” as “arising spontaneously or from an obscure or unknown cause.” By definition, this means idiopathic intracranial hypertension has no proximate cause. But that's not exactly true. This week on the podcast, we explore the evidence behind the theory that transverse sinus stenosis may contribute to this condition. Disclaimer: No chicken or eggs were harmed in the making of this episode.Produced by James E Siegler. Music courtesy of Squire Tuck, Swelling, Three Chain Links, and Unheard Music Concepts. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.REFERENCESDinkin MJ, Patsalides A. Venous sinus stenting in idiopathic intracranial hypertension: results of a prospective trial. J Neuroophthalmol 2017;37(2):113-21. PMID 27556959Farb RI, Vanek I, Scott JN, et al. Idiopathic intracranial hypertension: the prevalence and morphology of sinovenous stenosis. Neurology 2003;60(9):1418-24. PMID 12743224Gjerris F, Soelberg Sørensen P, Vorstrup S, Paulson OB. Intracranial pressure, conductance to cerebrospinal fluid outflow, and cerebral blood flow in patients with benign intracranial hypertension (pseudotumor cerebri). Ann Neurol 1985;17(2):158-62. PMID 3872097Karahalios DG, Rekate HL, Khayata MH, Apostolides PJ. Elevated intracranial venous pressure as a universal mechanism in pseudotumor cerebri of varying etiologies. Neurology 1996;46(1):198-202. PMID 8559374King JO, Mitchell PJ, Thomson KR, Tress BM. Manometry combined with cervical puncture in idiopathic intracranial hypertension. Neurology 2002;58(1):26-30. PMID 11781401Martins AN. Resistance to drainage of cerebrospinal fluid: clinical measurement and significance. J Neurol Neurosurg Psychiatry 1973;36(2):313-8. PMID 4541080Mohammaden MH, Husain MR, Brunozzi D, et al. Role of resistivity index analysis in the prediction of hemodynamically significant venous sinus stenosis in patient with idiopathic intracranial hypertension. Neurosurgery 2020;86(5):631-6. PMID 31384935Orefice G, Celentano L, Scaglione M, Davoli M, Striano S. Radioisotopic cisternography in benign intracranial hypertension of young obese women. A seven-case study and pathogenetic suggestions. Acta Neurol (Napoli) 1992;14(1):39-50. PMID 1580203Riggeal BD, Bruce BB, Saindane AM, et al. Clinical course of idiopathic intracranial hypertension with transverse sinus stenosis. Neurology 2013;80(3):289-95. PMID 23269597Rohr A, Dörner L, Stingele R, Buhl R, Alfke K, Jansen O. Reversibility of venous sinus obstruction in idiopathic intracranial hypertension. AJNR Am J Neuroradiol 2007;28(4):656

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.01.31.526446v1?rss=1 Authors: Wardman, J. H., Jensen, M. N., Andreassen, S. N., Styrishave, B., Wilhjelm, J. E., Sinclair, A. J., MacAulay, N. J. Abstract: Background: Idiopathic intracranial hypertension (IIH) is a condition characterized by increased intracranial pressure (ICP), impaired vision, and headache. Most cases of IIH occur in obese women of childbearing age, though age, BMI, and female sex do not encompass all aspects of IIH pathophysiology. Systemic metabolic dysregulation has been identified in IIH with a profile of androgen excess. However, the mechanistic coupling between obesity/hormonal perturbations and cerebrospinal fluid dynamics remains unresolved. Methods: Female Wistar rats were either fed a high fat diet (HFD) or exposed to adjuvant testosterone treatment to recapitulate IIH causal drivers. Cerebrospinal fluid (CSF) and blood testosterone levels were determined with mass spectrometry, ICP and CSF dynamics with in vivo experimentation, and the choroid plexus function revealed with transcriptomics and ex vivo isotope-based flux assays. Results: HFD-fed rats presented with increased ICP, which was not accompanied by altered CSF dynamics or modified choroid plexus function. Chronic adjuvant testosterone treatment of lean rats caused elevated CSF secretion rate, in association with increased activity of the choroid plexus Na+,K+,2Cl- cotransporter, NKCC1. Conclusions: HFD-induced ICP elevation in experimental rats did not originate from an increased rate of CSF secretion. Such modulation of CSF dynamics only came about with adjuvant testosterone treatment, mimicking the androgen excess observed in female IIH patients. Obesity-induced androgen dysregulation may thus play a crucial role in the disease mechanism of IIH. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Series 5 new episode is out now! Our host, leading Headache Specialist Dr Katy Munro discusses Idiopathic intracranial hypertension (IIH) with Professor Alex Sinclair and Dr Susan Mollan. Idiopathic intracranial hypertension (IIH), also known as benign intracranial hypertension or Pseudotumor cerebri, is a rare condition with an unknown cause or causes. The condition is associated with raised fluid pressure around the brain. Expert guests: Professor Sinclair is a Professor of Neurology at the University of Birmingham, and Head of the Metabolic Neurology Research Group. She is an international figure in translational research in Idiopathic Intracranial Hypertension (IIH), headache and traumatic brain injury. Dr Susan Mollan, is an Honorary Professor at the University of Birmingham and a Consultant Neuro-ophthalmologist at University Hospitals Birmingham. She is an International Senior Examiner for the Royal College of Ophthalmologists. If you have any questions/comments or any topics you would like us to cover in our future episodes email: info@nationalmigrainecentre.org.uk.   WE ARE A CHARITY Please help us keep going in the following ways: Please donate to help us continue to release new episodes: https://www.justgiving.com/campaign/headsup    Links mentioned in the episode 1. https://www.iih.org.uk/ 2. https://www.nhs.uk/conditions/intracranial-hypertension/  

Moderator: Dr. Konrad Weber (Zurich, Switzerland)Guest: Susan Mollan (Birmingham, United Kingdom)Starting off the month of Neuro-ophthalmology and -otology, Dr. Konrad Weber is joined by Dr. Susan Mollan from Birmingham to discuss the basics of idiopathic intracranial hypertension.

Invex Therapeutics (ASX: IXC) executive director and chief science officer Alex Sinclair joins Small Caps to discuss the company's Evolve phase III trial which is now underway and evaluating its lead drug Presendin in patients with idiopathic intracranial hypertension (IHH). IIH is a rapidly growing disease, with incidences rising 350% over the last 10 year. Around 240 newly diagnosed IIH patients will be recruited to the trial which will be open at 40 sites around the world. Articles:https://smallcaps.com.au/invex-therapeutics-recruiting-iih-patients-nz-clinical-trial-regulatory-approvals/https://smallcaps.com.au/invex-therapeutics-recruits-first-idiopathic-intracranial-hypertension-patient-presendin-trial/ For more information on Invex Therapeutics:https://smallcaps.com.au/stocks/IXC/See omnystudio.com/listener for privacy information.

November 2022 Journal Club Podcast Venous Sinus Stenting for Low Pressure Gradient Stenoses in Idiopathic Intracranial Hypertension To read the journal article: https://journals.lww.com/neurosurgery/Fulltext/2022/11000/Venous_Sinus_Stenting_for_Low_Pressure_Gradient.10.aspx Authors: P. Roc Chen, MD Guest Faculty: Waleed Brinjikji, MD Moderator: Haydn Hoffman, MD Committee Co-chair: Kimberly B. Hoang, MD

On today's edition of #TheDiamondKShow we talk: -‘The Woman King' poised for big box-office run. -Suspicious package found at Baltimore County school. -Baltimore judge vacates murder conviction of Adnan Syed Special guest interview with Shenee Woodson to discuss Idiopathic Intracranial Hypertension and "IIH Awareness Month"

Full article: https://www.ajronline.org/doi/abs/10.2214/AJR.22.27904  Eymen Ucisik, MD discusses a recently published AJR article aiming to explore the potential uses of MR Elastography in the diagnosis and monitoring of idiopathic intracranial hypertension. It is relevant for the radiology audience since MR elastography may potentially provide a noninvasive alternative to lumbar puncture in the evaluation of the intracranial pressure, although further studies are needed to support this proposal.

Can weight loss cure eye disease?Effectiveness of Bariatric Surgery vs Community Weight Management Intervention for the Treatment of Idiopathic Intracranial Hypertension.Can weight loss cure eye disease? In the case of Idiopathic Intracranial Hypertension (IIH), yes! A/Prof Clare Fraser talks us through the much-awaited follow-up article examining the Effectiveness of Bariatric Surgery vs Community Weight Management Intervention for the Treatment of IIH. The main take-away is not pizza – listen in to find out what is it!View article hereClare Fraser completed neuro-ophthalmic training at Moorfields Eye Hospital and the National Hospital for Neurology, London. She completed a research fellowship at Emory Eye Centre, Atlanta and was a consultant neuro-ophthalmologist for Moorfields Eye Hospital and Kings College Hospital, London. She is a senior clinical lecturer at the University of Sydney and Macquarie University and consults at St Vincent's Hospital, Sydney Eye Hospital and Macquarie University Hospital. She holds several National and International committee positions as a Director on the RANZCO Board and a reviewer for Clinical & Experimental Ophthalmology and The American Journal of Ophthalmology. 

Prof. Rigmor Jensen discusses psychiatric co-morbidities in patients with idiopathic intracranial hypertension. Read the full article in Neurology. Show references: https://n.neurology.org/content/99/2/e199

The focus of this episode is life as a veterinary technician with chronic disease. We had a few guests recently, and a few email requests for an episode with this kind of topic. Dani has been very open about her battle with fibromyalgia, and then post-COVID, which she had this past Christmas, she developed another condition called Idiopathic Intracranial Hypertension. We talked  about the path to finding the diagnoses, those difficulties, and how that has changed her career path. Caffeinators, if you are dealing with chronic health issues or know someone who is, this is the episode for you.   Follow us on Facebook: https://www.facebook.com/vettechcafe Follow us on Instagram: https://www.instagram.com/vettechcafepodcast Like and Subscribe on YouTube: https://www.youtube.com/channel/UCMDTKdfOaqSW0Mv3Uoi33qg  Our website: https://www.vettechcafe.com/ Vet Tech Cafe Merch: https://www.vettechcafe.com/merch If you would like to help us cover our podcast expenses, we'd appreciate any support you give through Patreon. We do this podcast and our YouTube channel content to support the veterinary technicians out there and do not expect anything in return! We thank you for all you do.

Idiopathic Intracranial Hypertension (IIH) is is a disorder of increased intracranial pressure that occurs mainly in overweight women of childbearing years. Having the commonest presentation of headache, we encounter of these patients quite often in acute setting. On this episode , we are talking about how we should approach in diagnosis and management. 

In this episode, we review the high-yield topic of Idiopathic Intracranial Hypertension (Pseudotumor Cerebri) from the Neurology section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets

Venous sinus stenting (VSS) is a safe, effective, and increasingly popular treatment option for selected patients with idiopathic intracranial hypertension (IIH). Serious complications associated with VSS are rarely reported. In this podcast, JNIS Editor-in-Chief, Felipe C. Albuquerque, interviews Dr. Kyle Fargen, from the Department of Neurosurgery, Wake Forest University, Winston-Salem, North Carolina, about a case series in which serious complications after VSS were identified retrospectively from multicenter databases. The cases are reviewed and learning points regarding complication avoidance and management are presented in his paper (https://jnis.bmj.com/content/early/2021/04/27/neurintsurg-2021-017361).

Invex Therapeutics (ASX: IXC) executive director Thomas Duthy joins Small Caps to discuss the company's new partnership with Korean biopharmaceutical company Peptron. The pair have signed an exclusive collaboration and manufacturing agreement that is expected to de-risk the development of Invex's lead drug Presendin for the treatment of idiopathic intracranial hypertension (IIH). The deal will grant Invex access to drug product, extensive data and Peptron's manufacturing and technical expertise, enabling it to bypass required activities saving both money and time in Presendin's development pathway.Article:https://smallcaps.com.au/invex-therapeutics-signs-major-collaboration-with-peptron/For more information:https://smallcaps.com.au/stocks/IXC/

REBEL Core Cast 65.0 – Idiopathic Intracranial Hypertension Click here for Direct Download of Podcast Post Peer Reviewed By: Salim R. Rezaie, MD (Twitter: @srrezaie) The post REBEL Core Cast 65.0 – Idiopathic Intracranial Hypertension appeared first on REBEL EM - Emergency Medicine Blog.

It's not a tumor!

Actor and fellow podcaster, Maddi Albregts speaks about IIH, internal ableism, and living with an invisible disability. Please check out her wonderful podcast BrainFart and add it to your playlist! Links for MaddiEpisode where Maddi is interviewed by her friend who took her to the hospital her sophomore year. One of my favorite episodes: HereLink to BrainFart homepage: HereLink to BrainFart IG Page: Here Links for The Landscape PagesLink to The Landscape FB PageLink to The Landscape Instagram PageLink to sign up News LetterLink to The Landscape LinkedIn

In this episode, I chat with Jen Roman, who is a fighter of Idiopathic Intracranial Hypertension. Jen Roman is a 27 year old living with Idiopathic Intracranial Hypertension & Behçets Disease. Instilled with a classic sense of Jersey-grit and a passion for helping others, she was a firefighter/EMT prior to her diagnosis and subsequent disability. After enduring ten brain procedures, Jen utilized her medical knowledge to become an expert, not only on the conditions that impact her, but also the technology that provides critical relief and management to her daily life. She spends most of her time fighting for legislation as a patient advocate, freelance writing, volunteering for multiple organizations, appearing on podcasts, and helping anyone who requires assistance on their medical journey. Jen is also a professional rock vocalist who aspires to bring her unique style and love of performance into her advocacy. Follow along on her advocacy journey! Instagram: https://www.instagram.com/kylo_jen_94/ --- Support this podcast: https://anchor.fm/theraredisorderpodcast/support

This week's interview is with an amazing, funny, and fascinating woman named Jen Roman! Jen is a rare disease patient whose life as an EMT was turned upside down, and since then, she has become well acquainted with spinal taps, brain surgeries, and unknown problems. Jen was diagnosed with Idiopathic Intracranial Hypertension, or IIH, which is a rare disease caused by an overproduction of cerebrospinal fluid. However, Jen's life is still full of unknowns because she has yet to pinpoint what caused her IIH. She and I talk about struggles of rare disease life, how a scientific occupation can change your perspective on diagnosis, and more! Be sure to subscribe to R is for Rare on Apple Podcasts, Spotify, or wherever you get your podcasts! Follow Jen Roman on Instagram - @kylo_jen_94 Jen's spotlight blog post on Our Odyssey - https://ourodyssey.org/our-odyssey-spotlight/jentruth Follow me on Instagram - @risforrarepodcast Questions? Email me at risforrarepodcast@gmail.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/annie-watson/message

Idiopathic intracranial hypertension (IIH, occasionally called pseudotumour cerebri or benign intracranial hypertension) is a condition characterised by features of raised intracranial pressure without any other cause identified. The main complication is progressive vision loss.  In this episode we discuss presentation, diagnosis and treatment. Follow us on Instagram @yourekiddingrightdoctors Facebook: https://www.facebook.com/yourekiddingrightpod-107273607638323/ Our email is yourekiddingrightpod@gmail.com Make sure you hit SUBSCRIBE/FOLLOW so you don’t miss out on any pearls of wisdom and RATE if you can to help other people find us! (This isn’t individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

In this episode we sit down with pediatric neurologist Dr. Ekta Bery to discuss the headache that is IIH (also known as pseudotumor cerebri) management. Pun intended. Don't forget to check out mdnotified.com for our QuickNotes and episode sources!

Idiopathic intracranial hypertension (formerly called pseudotumor cerebri) is a cause of headache, along with optic nerve edema, and can lead to permanent visual loss. This course will address how to diagnose it, how best to treat it, and other topics including subgroups and issues of “outliers.” This is a frequently missed diagnosis, and important to include in a differential diagnosis.

Maddi is a young adult currently dealing with several chronic diseases. She was diagnosed with including Idiopathic Intracranial Hypertension, PCOS, Hypothyroidism, and Lyme Disease all within the span of 3 years. She discusses what the process has been like for her. Website Instagram Facebook

Expert neuroophthalmologist Dr Anthony Fok takes us through the common but commonly vexing condition of intracranial atherosclerosis. We talk about how to assess IIH patients, how to manage them medically, when surgery is required, what to do when they don't tolerate the usual medications and more!

We discuss idiopathic intracranial hypertension, also known as pseudotumor cerebri, with frequent guest host Amanda Redfern. We chat about the diagnostic features, mechanism behind the symptoms, differential diagnosis and management

Conference is almost here! In the May 2019 episode of the JAAPA Podcast, hosts Adrian Banning and Kris Maday discuss clinical articles on describing fractures and idiopathic intracranial hypertension. Our hosts also tackle two colossal social topics: gender equality and diversity in the PA profession. Plus, why is Adrian double-checking her carry-on bag and what body part creeps out Kris the most? 

Host: Andrew Wilner, MD, FACP, FAAN As a follow-up to the Microgravity: A New Risk Factor for Idiopathic Intracranial Hypertension essay he wrote back in 2012, Dr. Andrew Wilner investigates whether there have been any updates on the 27 astronauts who had significant microgravity exposure.

Host: Andrew Wilner, MD, Author of "The Locum Life: A Physician's Guide to Locum Tenens" As a follow-up to the Microgravity: A New Risk Factor for Idiopathic Intracranial Hypertension essay he wrote back in 2012, Dr. Andrew Wilner investigates whether there have been any updates on the 27 astronauts who had significant microgravity exposure.

Host: Andrew Wilner, MD, Author of "The Locum Life: A Physician's Guide to Locum Tenens" As a follow-up to the Microgravity: A New Risk Factor for Idiopathic Intracranial Hypertension essay he wrote back in 2012, Dr. Andrew Wilner investigates whether there have been any updates on the 27 astronauts who had significant microgravity exposure.

Host: Andrew Wilner, MD, Author of "The Locum Life: A Physician's Guide to Locum Tenens" As a follow-up to the Microgravity: A New Risk Factor for Idiopathic Intracranial Hypertension essay he wrote back in 2012, Dr. Andrew Wilner investigates whether there have been any updates on the 27 astronauts who had significant microgravity exposure.

Host: Andrew Wilner, MD, Author of "The Locum Life: A Physician's Guide to Locum Tenens" As a follow-up to the Microgravity: A New Risk Factor for Idiopathic Intracranial Hypertension essay he wrote back in 2012, Dr. Andrew Wilner investigates whether there have been any updates on the 27 astronauts who had significant microgravity exposure.

Getting toot know you, getting toot know all about you... Maddi tells you the hard facts of her Pseudotumor and how she lives with Idiopathic Intracranial Hypertension. 

In collaboration with many different specialists, professions and patient representatives, Mollan et al (2018) have developed the first ever guidelines for the investigation and management of idiopathic intracranial hypertension (IIH). Senior author, Dr Alexandra Sinclair (University of Birmingham) discusses these with the JNNP podcast editor, Elizabeth Highton. Read the full guidelines here: https://jnnp.bmj.com/content/89/10/1088 Access the Practical Neurology infographic summary here: https://pn.bmj.com/content/early/2018/08/28/practneurol-2018-002009

This week we talk about the subacute headache and the dangerous, can't miss diagnoses of cerebral venous thrombosis and IIH https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_127_0_Final_Cut.m4a Download Leave a Comment Tags: Cerebral Venous Sinus Thrombosis, Headache, Neurology Show Notes Take Home Points Keep IIH and CVST on the differential for patient's coming in with a subacute headache, particularly if they have visual or neuro symptoms. Consider an ocular ultrasound! It's quick, shockingly easy to do, and can help point you toward a diagnosis you may have otherwise overlooked.  I have made it my practice now to include a quick look in the physical exam of my patients with a concerning sounding headache or a headache with neurologic symptoms.  Consider IIH particularly in an overweight female of child bearing age with a subacute headache, but remember patients outside that demographic can have IIH as well. Consider CVST in a patient with a thrombophilic process like cancer, pregnancy or the use of OCPs or androgens or in a patient with a recent facial infection like sinusitis or cellulitis. Read More WikEM: Idiopathic Intracra...

This week we talk about the subacute headache and the dangerous, can't miss diagnoses of cerebral venous thrombosis and IIH https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_127_0_Final_Cut.m4a Download Leave a Comment Tags: Cerebral Venous Sinus Thrombosis, Headache, Neurology Show Notes Take Home Points Keep IIH and CVST on the differential for patient’s coming in with a subacute headache, particularly if they have visual or neuro symptoms. Consider an ocular ultrasound! It’s quick, shockingly easy to do, and can help point you toward a diagnosis you may have otherwise overlooked.  I have made it my practice now to include a quick look in the physical exam of my patients with a concerning sounding headache or a headache with neurologic symptoms.  Consider IIH particularly in an overweight female of child bearing age with a subacute headache, but remember patients outside that demographic can have IIH as well. Consider CVST in a patient with a thrombophilic process like cancer, pregnancy or the use of OCPs or androgens or in a patient with a recent facial infection like sinusitis or cellulitis. Read More WikEM: Idiopathic Intracranial Hypertensi...

Idiopathic intracranial hypertension, also known as the pseudotumor cerebri syndrome, is characterized by elevated intracranial pressure with clinical features of headaches, vision impairment, and occasionally cranial nerve palsies in the absence of a structural lesion on neuroimaging. But that doesn't mean the neuroimaging has to be normal. See what Dr. Anita Kohli has to say about the radiographic correlates of IIH, their relevance, and their prognostic utility in this week's episode. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision making in routine clinical practice. REFERENCES 1. Friedman DI, Liu GT and Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology. 2013;81:1159-65. 2. Bidot S and Bruce BB. Update on the Diagnosis and Treatment of Idiopathic Intracranial Hypertension. Semin Neurol. 2015;35:527-38. 3. Agid R, Farb RI, Willinsky RA, Mikulis DJ and Tomlinson G. Idiopathic intracranial hypertension: the validity of cross-sectional neuroimaging signs. Neuroradiology. 2006;48:521-7. 4. Bidot S, Saindane AM, Peragallo JH, Bruce BB, Newman NJ and Biousse V. Brain Imaging in Idiopathic Intracranial Hypertension. J Neuroophthalmol. 2015;35:400-11. 5. Bidot S, Clough L, Saindane AM, Newman NJ, Biousse V and Bruce BB. The Optic Canal Size Is Associated With the Severity of Papilledema and Poor Visual Function in Idiopathic Intracranial Hypertension. J Neuroophthalmol. 2016;36:120-5. 6. Zagardo MT, Cail WS, Kelman SE and Rothman MI. Reversible empty sella in idiopathic intracranial hypertension: an indicator of successful therapy? AJNR American journal of neuroradiology. 1996;17:1953-6.

Valérie Biousse, MD

In this podcast, Dr Deborah Friedman expands upon themes raised in the recently published paper entitled “The Idiopathic Intracranial Hypertension Treatment Trial: Design Considerations and Methods”. The IIHTT is the first randomized, double-masked placebo-controlled trial to study the effectiveness of medical treatment for patients with IIH.

In this podcast, Drs. Karl Golnik and Andrew Lee continue their Point-Counterpoint discussion on the topic Optic Nerve Sheath Fenestration vs Cerebrospinal Diversion Procedures

This month Beau Bruce (assistant professor of ophthalmology and neurology, Emory University School of Medicine, Atlanta) discusses what we do and don’t know about idiopathic intracranial hypertension, and offers some clinical advice on the syndrome for neurologists.And Charles Bolton (professor in the Department of Medicine, Queen’s University, Ontario, Canada) talks us through his investigations in the 1980s which discovered critical illness could cause neurological problems.See also:Update on the pathophysiology and management of idiopathic intracranial hypertension http://tinyurl.com/bhjc9h6Polyneuropathy in critically ill patients http://tinyurl.com/bbze6jc