Idiopathic intracranial hypertension (IIH)
Medically reviewed by Kurt Yaeger, MD, endovascular neurosurgeon · Updated September 2026
Key points
Idiopathic intracranial hypertension (IIH), also called pseudotumor cerebri, is high pressure of the fluid around the brain. It commonly causes daily headaches, a pulsing sound in the ears, and blurred vision.
The biggest risk is permanent vision loss, so anyone with IIH should be followed closely by an eye doctor.
When medication is not enough, venous sinus stenting through a thin catheter can open a narrowed vein and relieve the pressure. A shunt is another option in selected cases.
What is IIH?
Idiopathic intracranial hypertension, sometimes called pseudotumor cerebri, is a condition where the pressure of the fluid around the brain is too high, without a tumor or other obvious cause. It most often affects young women, and it commonly causes daily headaches, a whooshing sound in the ears that beats with your pulse, and blurred or dimming vision.
The biggest concern is vision. High pressure can swell the optic nerves (papilledema), and if it goes untreated it can cause permanent vision loss. Anyone with IIH should be followed closely by an eye doctor.
Why the veins matter
In many people with IIH, the large veins that drain blood from the brain are narrowed where they leave the skull. This narrowing, called venous sinus stenosis, can keep pressure high in a self-reinforcing cycle. It is easy to miss on routine scans, so dedicated venous imaging, and sometimes a pressure measurement taken inside the vein, is often needed to find it.
How is it treated?
Treatment usually starts with medication and, when relevant, weight loss. When that is not enough, or vision is at risk, venous sinus stenting can be very effective: through a catheter, a small stent is placed to open the narrowed vein, which often relieves headaches, pulsing tinnitus, and pressure on the optic nerves. A VP shunt is another option in selected cases. I can perform both treatment options, and can best advise you on an option given your personal preferences and anatomy.