Diagnosis and Management of Idiopathic Intracranial Hypertension in Pregnant Patients

Idiopathic Intracranial Hypertension (IIH) is a rare neurological disorder characterized by increased intracranial pressure in the absence of an identifiable cause such as head trauma, stroke, or brain tumor. This condition presents with symptoms including severe headaches, papilledema (optic nerve swelling), and visual impairment. Diagnosis is based on clinical criteria, including the presence of papilledema, elevated lumbar puncture pressure, and a normal cerebrospinal fluid profile lacking inflammatory cells. The purpose of this review is to highlight the rising prevalence of IIH—especially among pregnant patients—and the pressing need for safer, more effective treatment options during pregnancy.

Between 2017 and 2022, the prevalence of IIH has increased from 7.3 (± 0.4) to 9.9 (± 0.4) cases per 100,000 individuals (Shaia et al. in Neurology 102(3):e208036, 2024). This notable rise signals a growing public health concern. While IIH is generally treatable, standard interventions such as weight loss, pharmacologic therapy, or surgical options pose significant risks during pregnancy. Many medications used in IIH management are not safe during the third trimester, and the effectiveness of weight loss as a treatment strategy is often limited or impractical during pregnancy. These challenges underscore the inadequacy of current management options for pregnant patients with IIH.

The increasing incidence of Idiopathic Intracranial Hypertension, particularly in pregnant patients, demands urgent clinical attention. The current treatment landscape presents substantial limitations for this demographic, emphasizing the need for alternative therapies that are both safe and effective during pregnancy. Future research must focus on developing and validating medication-based interventions that do not compromise maternal or fetal health. Addressing this gap is critical to improving outcomes and quality of life for pregnant individuals affected by IIH.