OpenTube

Headaches and Vision loss: What is IIH? (neurologist explains)

NeuroWorld-MD

2,675 views

This video gives a comprehensive overview into the diagnosis of idiopathic intracranial hypertension by discussing important information about common symptoms and treatments including weight loss, medications, and surgery. We discuss how idiopathic intracranial hypertension (also known as pseudotumor cerebri) is diagnosed by going through a patient's case, and we discuss the potential hidden dangers of papilledema. I’m Dr. Parker Bohm, a board-certified neurologist with a subspecialty in neuro-ophthalmology who completed residency training at the Mayo Clinic in Florida and fellowship at Washington University in St. Louis.

Amazon Affiliate links to interesting neurology books:
(As an amazon affiliate, once qualified I will earn a small commission from any books purchased from these links below. "As an Amazon associate I earn from qualifying purchases.")

The Man who Mistook his Wife for a Hat
https://amzn.to/3SaCxQT

Carrying the Black Bag: A Neurologist’s Bedside Tales
https://amzn.to/4zaszQ4

Brain on Fire (10th Anniversary Edition): My Month of Madness
https://amzn.to/4fUXSXH

One by One by One: Making a Small Difference Amid a Billion Problems – A Gripping Memoir of Global Health, Haiti, and Partners in Health
https://amzn.to/4hwlfrF

The New Parkinson's Disease Treatment Book: Partnering with Your Doctor To Get the Most from Your Medications
https://amzn.to/4bNV1x7

Timestamps:

0:00 - The Sneaky Neurologic Condition That May Cause Headaches & Blindness

0:45 - Patient Case: Severe Headaches & Whooshing in the Ears

1:44 - What is Papilledema? (Swollen Optic Nerves Explained)

2:44 - Brain Tumors, Blood Clots, & MRI Testing

3:56 - Diagnosing High Pressure with a Lumbar Puncture (Spinal Tap)

5:31 - What is Idiopathic Intracranial Hypertension (IIH)?

6:23 - The Most Feared Complication: Permanent Blindness

7:20 - IIH Risk Factors: Weight, Obesity, & Genetics. Who is Most Likely to Get IIH?

9:06 - Can Medications Cause High Spinal Fluid Pressure?

9:33 - Monitoring IIH: The Importance of Visual Field Testing

11:19 - How to Treat IIH: Weight Loss & Medications (Diamox)

13:28 - Invasive Treatments: Brain Shunts & Venous Sinus Stents

14:35 - Treating IIH Headaches AND Optic Nerve Swelling

15:38 - Patient Resolution: Reversing IIH & Regaining Quality of Life

The information on this channel is educational in nature and intended for a general audience. It is not intended or implied to be professional medical advice, diagnosis, or treatment given 1) every person is unique and may have specific, individual health considerations and 2) no medical evaluation is taking place or doctor-patient relationship formed given the one-way nature of the video content. Any content produced on this channel (including text, video, graphics audio, etc.) does not replace a consultation with your own doctor/health professional. If you have concerns regarding how this channel’s content applies to your health, please discuss with your own doctor/health professional. If you are concerned that you are having a medical emergency, contact emergency medical services immediately. Any content regarding patients' clinical cases may be fictionalized or have specific details changed without any intent to alter the overall educational goal.

18 Comments

@aldatgezeurmetinlogs 1 month ago

As someone who has IIH I cannot understand how a doctor can be more concerned about eyesight than overall quality of life. People with IIH are at increased risk of suicide and accidental overdose, likely because of the debilitating headaches that ruin your life. I lost weight which didn't help, I failed diamox cause I couldn't keep it down and now I have a stent thanks to an amazing interventional radiologist. The focus on eyesight-preservation almost kept me from getting this treatment. It helped. I am partly back at work and doing much better. Tip for fellow sufferers. Most people with pressure headaches do better when they're upright. So if you can, stay out of your bed during the day or sit up in it rather than lay down.

@katinchatt8525 1 month ago

Another great episode! I file these away in a "good to know" file. If you're ever inclined to do an episode on, Shingles WITHOUT rash, a lot of people may find it educational. I've just spent the last 3 weeks in abundant pain & waited too long for antivirals, there was No rash. I had radiation in the exact area 6 months ago. What a journey when it's not textbook. Of course I'm kicking myself for not getting the vaccine but will in a couple of months after I get my strength and immune system back on track.
Thank you so much for your time and doing the work in educating, and entertaining us.

@games-dan 1 month ago

Interesting video! I appreciate the changes to your editing and presentation compared with some of your previous videos, this feels less “gimicky” without the sound effects and such.

@chick-a-dee155 1 month ago (edited)

In case it helps anyone I have it from cranio cervical instability (cci). Most images won't show it. Get a digital motion x ray of your neck. It causes intercranial hypertension. IH also smashes your pituitary gland which can cause weight gain because it has a feedback loop with gut bacteria/leaky gut. It is more common in women because cci happens in women more because hormone changes contribute to ligament laxity. Some of these hormones are stored in fat. Your welcome, it is a huge rabbit hole. It is easy to look all this up and see the literature. Oh and the sound is from ijv compression near ear drum from the cci.

@dong4617 1 month ago

Pseudotumor cerebri

@KenGrimm1949 1 month ago

There is now another movie about Spinal Tap

@hyperjen1 1 month ago (edited)

Give the rest of the symptoms... a headache that gets worse with strain like bending over. Headaches when you cry. A pressure sensation behind the eyes. Does not get better when you lay down so it is not positional. But since you have high pressure you are more likely to get csf leaks. And you do not always have papel edema is not always present, some people with Iih have never had it. And most neurologists will ignore you...it is more common in people with EDS and it does not get better wjen you lose weight. And skinny people have it too.

@felixbouvet1746 1 month ago

Merci Monsieur c'est la première fois que j'entends parler de ce pathologie alors je ne savais pas que j'avais un doute de toute façon que vous allez parler du surpoids je sais pas pourquoi et bien voilà ça vient du surpoids mais on sait pas exactement ça je savais pas qu'on leur presque 13 privé chez eux une analgésie puissante et des ponctions lombaires je savais pas que ça pouvait endommager la vision par contre je n'ai jamais fait le test du test de vision périphérique qui l'ophtalmo ça me dit rien du tout moi j'ai lu que le test pour la pression de mes yeux et ils étaient très bonnes c'est un petit coup d'air sec qu'on reçoit sur les yeux en moins de 1 secondes ça pique un peu mais ça va très vite mais merci beaucoup bravo pour cette femme

@Sandi_Hurd 1 month ago

I must admit, I am a bit shocked. The last time I heard a neurologist associate IIH with obesity was about 15 years ago. And although paps are often discovered in people with IIH, paps do not need to be present for an IIH diagnosis. The reason there seems to be a rising number of cases is more likely because when a patient talks to their doctor about their symptoms or they go to the ER, the doctors are actually looking for the condition vice dismissing the symptoms as everything from depression, seeking attention, hypochondria, hormone changes, obesity, and the list goes on.

@SheWolf1968 1 month ago

I've got severe tunnel vision

@julesreyes1329 1 month ago

I have IIH and not only can I hear my pulse (Pulsatile Tinnitus) but I can also see my pulse. So far my Neuro Opthamologist doesn't know what to do with that little bit of knowledge.

@Stes-i3r5n 1 month ago

I get headaches that no one has been able to diagnose. They are like the Chinese water torture, except the water is replaced by daggers dropped from 20 feet up, 3 to 4 times a minute. They last 3 to 10 days with 7 being the average. I get them once or twice a year usually in the spring or fall but not always can be any time. I have been getting these for a little over 20 years. They know what they are not, but no one can tell me what they are. Oh yes no one gives me anything for the pain, nothing over the counter touches it.

@Backgrounds0321 1 month ago (edited)

Maybe breast neck hypertension and with the males do they have 2 X chromosomes? + sexual relief medication for spinal fluid release vitamin A supplements pressure to central nervous system the further I go I end up realizing how complex it can be menstrual periods
Heart failure fluid build up into the gums elevated pulse rates from stress anxiety hyper tension from nerves overworking for too long also I think it's possible when a doctor or nurse see's a patient rubbing 2 or 3 fingers on the veins horizontal from their eye lids could be a sign

@shhhhhhh9328 1 month ago

Estrogens maybe?

@janeshipley6993 1 month ago (edited)

you did a good job explaining iih. but please, for crying out loud, be one of the first to quit saying what you did after you first used the terms iih and papilledema! we are not idiots - we can look it up in two seconds. it’s so damn patronizing. “ooooh, it’s one of those big medical words that you couldn’t possibly understand!” pullease! sure, explain what something means, but please don’t say things like “it’s a fancy medical word” or “that’s a big medical word for.” thank you. rant over.

@dacisky 1 month ago

I'm really enjoying your series,but am afraid YT's new stupid,ai algorithm is going to wipe the floor with you.

@planesight1142 1 month ago

it's called bending your neck down and STARING AT A CELLPHONE!! ....remember kids, don't sit too close to the TV

@spvillano 1 month ago

Interesting. I can see missed diagnosis easily occurring by not examining the retina or looking for other signs of CSF hypertension, likely mistaken for migraine.
Questions: Is there a commonality present in lipid profile or hydrion/bicarbonate chemistry? That could suggest one of two mechanisms of loss of flow of CSF toward the venous system and the latter being suggested in some cases given the pharmacology of acetazolamide and hydrion/bicarbonate levels, perhaps both being elevated influencing osmotic action?
Just a couple of odd notions...