Idiopathic Intracranial Hypertension (IIH): Also Called Pseudotumor Cerebri: Why It Gets Migraine, How Sight Is Lost Without Warning, and What the New Weight Drugs Actually Do

One patient in three feels their sight is affected. Three in five already have measurable loss.Idiopathic intracranial hypertension - also called pseudotumor cerebri - is a disease in which the loud symptom and the dangerous one are not the same thing.The headache is what brings almost everyone to a doctor. It is also the least informative thing about the illness: there is no characteristic headache here, which is why so many patients are treated for migraine for years while the real problem goes unexamined. Meanwhile the damage starts at the edges of vision, below the midline, in arcs - and central vision, the part that reads a page and recognises a face, is the last thing to go. People lose a third of their visual field without noticing anything at all.Written by a practising neurologist, this book is built around that gap: what a proper evaluation actually looks like, why a ninety-second examination of the optic discs keeps not being done, and how to tell a real diagnosis from the two-in-five referrals that turn out to be something else.What this book covers- Why it gets mistaken for migraine - and why a headache description cannot make or exclude the diagnosis- What a proper workup is, in order: fundus examination, formal visual fields, OCT, imaging including venography, and the lumbar puncture- How sight is lost without warning, and what the monitoring tests can see that you cannot- Acetazolamide and topiramate - what the trials actually showed, including the side effects patients are not warned about- The GLP-1 drugs: pressure fell within two and a half hours of a single injection, far too fast for weight loss to explain it - and why that trial had fifteen completers- The weight conversation, handled honestly rather than avoided- Fulminant disease: the two to three per cent who lose sight over days, and what to say to get seen today- Venous sinus stenting, shunts and their revision rate, and optic nerve sheath fenestration, compared side by side- The headache that outlasts the treatment - including the CGRP antibody evidence, and the safety warning that comes with it- Brain fog, pulsatile tinnitus, work, driving, pregnancy, and what happens if sight is lost anywayEvery figure is tied to a numbered reference - 174 of them, drawn from the published literature. Where two good studies disagree, both appear. Where the evidence does not exist - on flying, on lifting, on what this disease does to a career - the book says so plainly instead of inventing an answer.It includes a one-page suspect-confirm-treat chart written to be photographed and taken to an appointment.Tae Ho Guak, MD, is a neurologist with thirty years in medicine, twenty-five of them in headache.