Idiopathic Intracranial Hypertension, previously known as pseudotumor cerebri, can be treated with medications such as carbonic anhydrase inhibitors (i.e. acetazolamide), corticosteroids, indomethicin, loop diuretics, and analgesics used to treat migraine headaches.
While removing excess cerebrospinal fluid (CSF) via lumbar puncture (LP) is sometimes considered to be an appropriate therapeutic intervention for IIH in the emergency department, it is generally not recommended for the following reasons:
-- CSF reforms within 6 hours, making its removal short-term, unless there is a CSF leak.
-- LP can be challenging in obese patients and uncomfortable for patients, in general.
-- LP complications such as low pressure headaches, CSF leak, CSF infection, and intraspinal epidermoid tumors.
References
Corbett JJ, Mehta MP. "Cerebrospinal fluid pressure in normal obese subjects and patients with pseudotumor cerebri." Neurology. 1983 Oct;33(10):1386-8.
