Mildly elevated intracranial pressure appears to be a distinct pathology separate from idiopathic increased intracranial pressure and migraine. Many patients present with head fullness-pressure and dizziness, which is often suggestive of a clinical diagnosis of vestibular migraine. These patients may additionally have episodic vertigo as seen in endolymphatic hydrops and positional vertigo in addition to feeling dizzy. In most cases, hearing is normal. A long duration of the condition or a presence of associated ear pathologies, i.e., dehiscence, fistula, hypermobile footplate, or history of chronic ear infections can add hearing loss to clinical presentations. Low-pitch pulsatile tinnitus, when present, is an important symptom. The neuroimaging findings such as partially empty sella, blockage of the dural venous sinus or sigmoid sinus wall defects are frequently observed. The condition is diagnosed by measuring the lumbar puncture opening pressure. Typically, patients have normal cerebrospinal fluid chemistry and microscopy. Lowering the pressure during the lumbar puncture will resolve the patient\'s symptoms temporarily. Medical therapy is typically successful using carbonic anhydrase inhibitors and corrections of medical disorders that may be contributing to the increased pressure. A few require shunting or stenting procedures. In this review article, we define the condition in detail with illustrative cases that we collected from our practices.

This study sought to characterize the optic disc morphology, particularly the cup-to-disc ratio of the optic nerve head in children with idiopathic intracranial hypertension. The medical charts and digital optic disc photos of children with confirmed diagnosis of idiopathic intracranial hypertension were reviewed retrospectively. The optic disc area, cup area, and cup-to-disc ratio were measured digitally using VISUPAC software, and the mean values of those parameters were compared to the published norms. Of children with idiopathic intracranial hypertension, 83% had absence of the physiological cup of the optic disc, compared to 10% of children in the general population of the same age. The median disc area was 2.2 mm(2), and median cup area was 0.0mm(2), compared to the published norms of 2.69 mm(2) and 0.44 mm(2), respectively. There is very significantly high prevalence of small optic disc cups in children with idiopathic intracranial hypertension, with the cup being absent on majority of cases in our patient cohort. This may signal an underlying systemic predisposition to the development of intracranial hypertension.