Question

Benign intracranial hypertension: 
Causes. 
 

Hint:

When assessing a patient for BIH, always consider secondary causes like venous sinus thrombosis and chronic kidney disease, especially in patients with other underlying conditions.

Answer 1

Step 1: Identifying Primary Causes.
The causes of benign intracranial hypertension (BIH) can be categorized into primary (idiopathic) and secondary causes.

Step 2: Primary (Idiopathic) BIH.
In most cases, BIH is idiopathic, meaning that no underlying cause can be identified. However, there are known risk factors, including:
1. Obesity: Particularly in young women, obesity is the most significant risk factor for developing BIH.
2. Female gender: Women, especially those of childbearing age, are more likely to develop BIH.
3. Medications: Certain medications, such as oral contraceptives, tetracycline antibiotics, and corticosteroids, can contribute to BIH.

Step 3: Secondary Causes of BIH.
Secondary causes of increased intracranial pressure that could mimic BIH include:
1. Venous sinus thrombosis: Blood clots in the venous sinuses can obstruct CSF drainage, leading to increased pressure.
2. Chronic kidney disease: Renal insufficiency can lead to fluid retention and elevated ICP.
3. Endocrine disorders: Conditions like hyperthyroidism and Cushing's syndrome can increase the risk of BIH.

Step 4: Conclusion.
The majority of BIH cases are idiopathic, but obesity, female gender, and certain medications are major risk factors. Secondary causes should always be ruled out when diagnosing BIH.