Related Experiment Video
Updated: Jul 8, 2026

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Fulminant Idiopathic Intracranial Hypertension-Clinical Characteristics and Continuous Drainage as a Novel Treatment
Yoel Schwartzmann1,2, Samuel Moscovici2,3, Dana Ekstein1,2
1Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Background:
Fulminant idiopathic intracranial hypertension (fIIH) is a severe condition which causes rapid visual loss. Conventional fIIH management involves surgical interventions, but their effectiveness and safety remain uncertain. The use of temporary continuous CSF drainage (CD) for fIIH has not been fully explored in the adult population. We present the results of CD treatment in severe IIH cases.
Method:
IIH Patients treated with CD were compared to control groups of extreme CSF opening pressure (> 45 cm H2O) and random IIH patients (> 25 cm H2O).
Results:
Eighteen female patients underwent CD treatment. Indications for CD treatment were acute visual deterioration or development of a VI nerve palsy and severe papilledema (despite acetazolamide treatment). All patients stabilized after CD treatment. Four patients had acute complications that fully resolved. Visual acuity (VA) in fIIH patients was significantly reduced prior to treatment (mean 6/15 ± 6/19 vs. 6/7.5 ± 6/30, p < 0.01). CD treatment resulted in marked long-term improvement in VA (mean 6/7.5 ± 6/19 vs. 6/7 ± 6/38, p = 0.12 and 6/7 ± 6/48, p = 0.05). Compared to the extreme CSF opening pressure group, female sex, obesity, and TVO's were more common in the CD group. Compared to the general IIH group, female sex, obesity, endocrinopathy, and CSF opening pressure were higher in the CD group.
Conclusion:
IIH patients with very high CSF opening pressure and the presence of obesity and endocrinopathy may be at higher risk to develop fIIH. CD treatment is an extremely effective and safe treatment option for severe cases of IIH.
Related Concept Videos
Increased Intracranial Pressure l: Introduction
Angle Closure Glaucoma: Treatment
Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
Increased Intracranial Pressure ll: Pathophysiology
Brain Abscess l: Introduction
Glaucoma: Overview