Management of idiopathic intracranial hypertension in pregnancy

Lachlan Andrew Byth; Karin Lust; Rosalind L Jeffree; Mark Paine; Lucie Voldanova; Ann-Maree Craven

doi:10.1177/1753495X211021333

Management of idiopathic intracranial hypertension in pregnancy

Obstet Med. 2022 Sep;15(3):160-167. doi: 10.1177/1753495X211021333. Epub 2021 Jun 9.

Authors

Lachlan Andrew Byth^{1

2}, Karin Lust^{1

3}, Rosalind L Jeffree^{4

3}, Mark Paine⁵, Lucie Voldanova⁶, Ann-Maree Craven¹

Affiliations

¹ Department of Obstetric Medicine, Royal Brisbane and Women's Hospital, Herston, Australia.
² Griffith University School of Medicine, Southport, Australia.
³ University of Queensland School of Medicine, Herston, Australia.
⁴ Department of Neurosurgery, Royal Brisbane and Women's Hospital, Herston, Australia.
⁵ Department of Neurology, Royal Brisbane and Women's Hospital, Herston, Australia.
⁶ Department of Anaesthesia, Royal Brisbane and Women's Hospital, Herston, Australia.

Abstract

Idiopathic intracranial hypertension is more common among women of reproductive age and is often encountered in pregnancy, either pre-existing and exacerbated by pregnancy-associated weight gain and hormonal changes or arising de novo. We report the case of a 33-year-old woman with progressive visual loss and intractable headache from 20 weeks' gestation requiring ventriculoperitoneal shunting during pregnancy. The risk of permanent maternal vision loss raises complex management dilemmas, when this must be balanced with the fetal and neonatal risks of treatment and possible premature delivery.

Keywords: Idiopathic intracranial hypertension; gestational weight gain; headache; pregnancy; pseudotumor cerebri.

Publication types

Review