Intracranial Hypertension

Most of us are familiar with hypertension, or high blood pressure, but have never heard of intracranial hypertension—high fluid pressure inside the head. Intracranial hypertension was originally known as pseudotumor cerebri (“false brain tumor”) because its symptoms—unbearable headaches, vision changes and ringing in the ears—closely resemble those of a brain tumor.

Intracranial hypertension is neither a brain tumor nor a result of high blood pressure. Instead, researchers believe that cerebrospinal fluid (CSF, normal fluid created within the brain) does not reabsorb or drain properly into the major veins of the brain, which raises the pressure of the CSF inside the skull. Elevated cerebrospinal fluid pressure can cause headaches, and also exert pressure on the optic nerve and its blood supply, leading to swelling of the optic nerve (papilledema) and visual symptoms, including blindness. Narrowing of the major veins inside the skull may also contribute to intracranial hypertension, but researchers do not yet fully understand the mechanisms of the disease. A pulse-like ringing in the ears (pulsatile tinnitus) is likely a result of turbulence of blood flow in the major veins within the head from areas of high pressure to areas of lower pressure in the jugular veins of the neck.

Approximately one or two people out of 100,000 suffer from intracranial hypertension but that number may be as high as 21 out of 100,000 for obese women under the age of 44—the population hit hardest by this disease. Even as the number of people with intracranial hypertension continues to grow, few centers in the United States offer both seamless patient care and the ability to take on research to advance its diagnosis and treatment. The Intracranial Hypertension Program at UW Medicine fills that gap.

Patient Information

At the Intracranial Hypertension Program at UW Medicine, we understand the physical and emotional toll of this disease, and have designed our treatment program accordingly. We strive to offer seamless, multidisciplinary patient care that will alleviate your suffering and the worry that tends to go along with it.

Our patient care coordinator serves as a single point of contact from your initial visit through any additional specialist consultations that you may need. At your first visit, you will see several specialists on the same day so that you may receive fast, accurate evaluations and diagnoses. If you require consultation with additional UW Medicine specialists, including experts in sleep medicine, bariatric medicine, neuroimaging and psychiatry, we facilitate your access to these specialists and share your diagnosis and treatment plan with them. Treatment usually begins with lifestyle changes and drug therapy, and may eventually progress to surgical options when indicated.

In addition to providing outstanding patient care, our UW Medicine specialists are at the forefront of research to improve care and advance scientific knowledge in the diagnosis and treatment of intracranial hypertension. You may have the opportunity to participate in clinical trials of new diagnostic and treatment methods should you so choose.

Your Care Team

​​

Michael A. Williams M.D.
UW professor of neurology and neurological surgery​

Michael Levitt M.D.
UW assistant professor of neurological surgery and radiology

​​Courtney Erin Francis M.D.

UW Ophthalmology director of medical student education​.

Sylvia Maria Lucas M.D., Ph.D.
UW clinical professor of neurology and neurological surgery and adjunct clinical professor of rehabilitation medicine.

Research/Education

Our research program dedicates its efforts to identifying the best diagnostic and treatment methods for intracranial hypertension. Our researchers focus on identifying novel biomarkers of the disease and developing noninvasive diagnostic methods, such as MRI phase contrast venography. By maintaining a long-term registry of patient data, we can deepen our understanding of the long-term effects of intracranial hypertension. This registry allows us to track current patients and recruit others for multicenter trials.

Educating and training the next generation of physicians is another core focus of our program; we are developing specific post-graduate training in the ophthalmological, neurological and neurosurgical aspects of this and other related diseases. This training will provide a solid educational foundation for residents and fellows who wish to develop expertise in intracranial hypertension and related conditions. Additionally our trainees will partner with leading experts from across the country so as to stay up to date on the most current information in the field.

To learn more about the Intracranial Hypertension program at UW Medicine, contact Colin Dierckins, assistant director for philanthropy, at 206.685.4589 or at cdierck@uw.edu​.​