Intracranial hypertension (2024)

Intracranial hypertension (IH) is a build-up of pressure around the brain.

It can happen suddenly, for example, as the result of a severe head injury, stroke or ruptured brain aneurysm.

It can be caused by a condition that affects your brain, such as a brain abscess, brain tumour, meningitis or encephalitis.

IH can also develop as a complication of another condition such as high blood pressure.

Treatment for these types of IH depends on the cause.

Sometimes though there is no obvious reason why pressure builds up around the brain. Build-up of pressure with no known cause is known as idiopathic intracranial hypertension.

This page is about idiopathic intracranial hypertension.

Symptoms of intracranial hypertension

Symptoms of intracranial hypertension (IH) can include:

  • a constant throbbing headache which may be worse in the morning, or when coughing or straining; it may improve when standing up
  • temporary loss of vision – your vision may become dark or "greyed out" for a few seconds at a time; this can be triggered by coughing, sneezing or bending down
  • feeling and being sick
  • feeling sleepy
  • feeling irritable
  • finding it difficult or painful to look at bright lights (photophobia)
  • hearing a pulsing rhythmic noise in your ears (pulsatile tinnitus)
  • problems with co-ordination and balance
  • mental confusion
  • loss of feeling or weakness

Immediate action required: Call 999 or go to A&E if you have any of these symptoms and:

  • they've come on quickly, such as a sudden severe headache, change in your vision, confusion or weakness
  • you've recently had a head injury
  • you have a high temperature, or you feel generally unwell

Diagnosing intracranial hypertension

A GP may suspect you have intracranial hypertension (IH) if you have symptoms of increased pressure on your brain, such as vision problems and headaches.

If a GP thinks you have IH they'll refer you to a hospital specialist.

You may have several different tests to diagnose IH, such as:

  • an examination to check functions such as your muscle strength, reflexes and balance. Any problems could be a sign of an issue with your brain or nerves
  • an assessment of your eyes and vision
  • a CT scan or MRI scan of your brain
  • a lumbar puncture, where a needle is inserted into your spine to check for high pressure in the fluid that surrounds your brain and spinal cord

Idiopathic IH may be diagnosed if you have increased pressure on your brain and no other cause can be found.

Treatments for idiopathic intracranial hypertension

Treatments for idiopathic intracranial hypertension (IH) can include:

  • losing weight if you're overweight. This can often help to reduce your symptoms and may sometimes relieve them altogether
  • stopping any medicine that may be causing your symptoms
  • medicine to remove excess fluid from the body (diuretics)
  • medicine to reduce the production of cerebrospinal fluid in your brain
  • a short course of steroid medicine to relieve headaches and reduce the risk of vision loss


Surgery may be considered if other treatments do not help, particularly if your vision is getting worse or you're at risk of loss of vision.

The main types of surgery for idiopathic IH are:

  • shunt surgery – a thin, flexible tube is inserted into the fluid-filled space in your skull or spine to divert excess fluid to another part of your body
  • optic nerve sheath fenestration – the protective layer surrounding your optic nerve (the nerve connecting the eye to the brain) is opened up to relieve pressure on it and allow fluid to drain away

These procedures can provide relief from your symptoms, but they also carry a risk of potentially serious complications. Talk to the surgeon about what your operation involves and what the risks are.

Risk factors for idiopathic intracranial hypertension

While the cause, or causes, of idiopathic IH is unknown, a number of risk factors have been linked to the condition.

It's a rare condition that mainly affects women in their 20s and 30s. It most often happens in women who have gained weight. The reason for this is unclear.

Other factors that have been linked with idiopathic IH include:

  • some hormone conditions such as hypoparathyroidism or Addison’s disease
  • taking certain medicines including some antibiotics, lithium (for mental health problems) and medicines for thyroid problems
  • high levels of vitamin A
  • a lack of red blood cells (iron deficiency anaemia)
  • lupus – a problem with the immune system

Complications of idiopathic intracranial hypertension

Idiopathic IH is not usually life threatening, but it can be a lifelong problem.

It can affect your vision, and there's a risk that you could lose your vision. This is because the increased pressure around the brain can cause swelling of the optic nerve.

Treatment can help with problems with your vision and can reduce the risk of loss of vision.

It's important to tell your doctor straight away if you notice any changes in your vision.

Find out more about living with idiopathic IH from the IIH UK website.

Page last reviewed: 28 March 2023
Next review due: 28 March 2026

Intracranial hypertension (2024)


What is the most common cause of intracranial hypertension? ›

Common symptoms of intracranial hypertension are headache and vision problems. The most common cause of this condition in children and adults is obesity. However, many patients have the condition even if they are not overweight.

Can you live a normal life with intracranial hypertension? ›

Most people with IIH lead relatively normal lives. The only change for most patients is a daily medication and regular eye exams. Sometimes, for those patients who are an unhealthy weight, losing weight is all that is needed to control their IIH.

Can intracranial hypertension resolve itself? ›

IIH may go away on its own. You may need any of the following if your symptoms continue or get worse: Medicines may be given to control migraines or decrease the amount of CSF you produce. This will help relieve pressure in your skull.

Does IIH ever go away? ›

IIH is rarely curable, but weight loss, medications and surgery can significantly reduce symptoms and preserve vision. For people with venous stenosis and IIH, venous stenting is a very effective treatment.

What are the four stages of intracranial pressure? ›

Intracranial hypertension is classified in four forms based on the etiopathogenesis: parenchymatous intracranial hypertension with an intrinsic cerebral cause, vascular intracranial hypertension, which has its etiology in disorders of the cerebral blood circulation, meningeal intracranial hypertension and idiopathic ...

What foods should you avoid with intracranial hypertension? ›

Patients should also generally avoid foods that are high in vitamin A or tyramine. You may need to limit the consumption of certain vegetables like leafy greens, carrots, tomatoes, and sweet potatoes. Preserved and smoked foods like pepperoni, pickles, aged cheese, salami, beer, and wine should be avoided.

What does intracranial pressure feel like? ›

a constant throbbing headache which may be worse in the morning, or when coughing or straining; it may improve when standing up. temporary loss of vision – your vision may become dark or "greyed out" for a few seconds at a time; this can be triggered by coughing, sneezing or bending down. feeling and being sick.

Does caffeine increase intracranial pressure? ›

Conclusions: This study demonstrates that caffeine has a lowering effect on ICP as an acute treatment. Interestingly, caffeine acutely caused an increased response in cephalic thresholds supporting hypoalgesic effects. Future studies investigating the beneficial effects of caffeine for elevated ICP are warranted.

Can stress raise intracranial pressure? ›

Oxidative stress is an important pathophysiological mechanism that causes intracranial hypertension, rendering oxidative stress as a potential target for the treatment of intracranial hypertension.

What is life expectancy with IIH? ›

IIH does not normally affect life expectancy. The major complications from IIH arise from untreated or treatment-resistant papilledema. In various case series, the long-term risk of one's vision being significantly affected by IIH is reported to lie anywhere between 10 and 25%.

Can IIH cause stroke? ›

The researchers found that women with IIH were twice as likely to be at risk of cardiovascular disease, including heart failure and stroke, as women of the same weight and age without IIH.

What triggers IIH? ›

It occurs because of cerebrospinal fluid (CSF) buildup around your brain. When CSF builds up in your skull, it can put pressure on your optic nerve, the nerve that helps you see. Symptoms of IIH might include vision changes, headaches or temporary blindness.

Which injury is the most likely cause of elevated intracranial pressure? ›

The pressure can damage the brain or spinal cord by pressing on important structures and by restricting blood flow into the brain. Many conditions can increase intracranial pressure. Common causes include: Aneurysm rupture and subarachnoid hemorrhage.

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