Benign Intracranial Hypertension Associated With Hypervitaminosis A

Abstract

MANY explanations have been proposed concerning the etiology of benign intracranial hypertension (BIH).^1-109The syndrome includes headache, papilledema, increased intracranial pressure, and occasional related visual field defects and sixth nerve palsies.^1-10The patients are alert, and the electroen-cephalogram is usually normal,¹¹as are the cerebrospinal fluid (CSF) protein level and cell count. Pneumoencephalogram shows a normal or small ventricular system, and no obstruction of extracerebral CSF patterns.^1-7Brain edema has been noted on biopsy, with swelling of all cellular elements.¹²Papilledema can occasionally be so severe as to constitute a threat to vision.⁷The majority of patients experience a self-limiting course, with rare recurrence.¹³ Implicated as causative factors have been the following: (1) obstruction or impairment of intracranial venous drainage^7,14-28; (2) endocrine and metabolic dysfunctions,^29-43including obesity,^30-33menstrual disorders,^34,35pregnancy,^36,37menarche,³⁸Addison's disease,³⁹and hypoparathy-roidism^40-42; (3) exogenously administered drugs,^44-62including adrenal steroids,^44-51female sex hormones,^52-54antibiotics,^55-61and psychotherapeutic drugs⁶²; and