Idiopathic Intracranial Hypertension - History

History

The first report of IIH was by the German physician Heinrich Quincke, who described it in 1893 under the name serous meningitis. The term "pseudotumor cerebri" was introduced in 1904 by his compatriot Max Nonne. Numerous other cases appeared in the literature subsequently; in many cases, the raised intracranial pressure may actually have resulted from underlying conditions. For instance, the otitic hydrocephalus reported by London neurologist Sir Charles Symonds may have resulted from venous sinus thrombosis caused by middle ear infection. Diagnostic criteria for IIH were developed in 1937 by the Baltimore neurosurgeon Walter Dandy; Dandy also introduced subtemporal decompressive surgery in the treatment of the condition.

The terms "benign" and "pseudotumor" derive from the fact that increased intracranial pressure may be associated with brain tumors. Those patients in whom no tumour was found were therefore diagnosed with "pseudotumor cerebri" (a disease mimicking a brain tumor). The disease was renamed "benign intracranial hypertension" in 1955 to distinguish it from intracranial hypertension due to life-threatening diseases (such as cancer); however, this was also felt to be misleading because any disease that can blind someone should not be thought of as benign, and the name was therefore revised in 1989 to "idiopathic (of no identifiable cause) intracranial hypertension".

Shunt surgery was introduced in 1949; initially, ventriculoperitoneal shunts were used. In 1971, good results were reported with lumboperitoneal shunting. Negative reports on shunting in the 1980s led to a brief period (1988–1993) during which optic nerve fenestration (which had initially been described in an unrelated condition in 1871) was more popular. Since then, shunting is recommended predominantly, with occasional exceptions.