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E11. Idiopathic intracranial hypertension (Pseudotumor cerebri syndrome)

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Most common in Obese women
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์ธ์ง€ํ•˜์ง€ ๋ชปํ•˜๊ฑฐ๋‚˜ ์ ์ ˆํžˆ ์น˜๋ฃŒํ•˜์ง€ ๋ชปํ•˜๋ฉด ์˜๊ตฌ์ ์ธ ์‹œ๋ ฅ ์†์ƒ ๊ฐ€๋Šฅ

(1) ์ฆ์ƒ

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๋‘ํ†ต
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Transient visual obscurations
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Back pain
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Pulsatile tinnitus
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Visual loss

(2) ์ง„๋‹จ criteria

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Papilledema (POCUS ์ƒ ONSD ์ฆ๊ฐ€, Optic disc elevation),
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์š”์ถ”์ฒœ์ž ์‹œ opening pressure ์ฆ๊ฐ€ (>25 cmH2O)
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CSF study๋Š” ์ •์ƒ
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๋‡Œ์˜์ƒ๊ฒ€์‚ฌ๋Š” ๋Œ€๊ฐœ ์ •์ƒ์ด์ง€๋งŒ ํŠน์ง•์ ์ธ finding์„ ๋ณด์ผ ์ˆ˜ ์žˆ๋‹ค

(3) ์น˜๋ฃŒ : ์‹œ๋ ฅ๋ณด์กด์ด ๋ชฉํ‘œ

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15~20 cmH2O ๊ฐ€ ๋  ๋•Œ๊นŒ์ง€ CSF๋ฅผ ๋นผ ๋ณผ ์ˆ˜ ์žˆ๋‹ค
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์ผ๋ฐ˜์ ์œผ๋กœ 1mL ์ œ๊ฑฐํ•  ๋•Œ ๋งˆ๋‹ค 1 cmH2O ๊ฐ์†Œ. ์ฆ์ƒ์˜ ์ผ์‹œ์  ์™„ํ™” ๊ฐ€๋Šฅ
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PO acetazolamide 250~500mg BID (max 4g/d ๊นŒ์ง€ ์ฆ๋Ÿ‰ ๊ฐ€๋Šฅํ•˜๋‚˜ ๋ถ€์ž‘์šฉ๋„ ์ฆ๊ฐ€) โ†’ ICP๋ฅผ ๋‚ฎ์ถฐ์คŒ
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Long term plan : Weight loss for obese / CSF shunting / Optic nerve sheath fenestration