A formal diagnosis of IIH requires strict adherence to all criteria to ensure correct differentiation from secondary intracranial hypertension.
Diagnostic Sentinel Probe
Identify the six mandatory laboratory and laboratory findings to establish a high-authority diagnosis of IIH and exclude secondary mimicries.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Confirming or excluding a diagnosis of Idiopathic Intracranial Hypertension (IIH/Pseudotumour Cerebri) before initiating Acetazolamide therapy or surgical CSF diversion.
Triaging the cause of papilledema — ruling out mass-lesion, venous sinus thrombosis, and meningitis first.
Section 2
Literature
Development
The original Dandy Criteria were first published in 1937, establishing IIH as a diagnosis of exclusion. They were revised by Smith (1985) and further modified by Friedman & Jacobson (2002) to account for modern neuroimaging, standardised lumbar puncture technique, and the absence of papilledema in some atypical cases.
Section 3
Pearls/Pitfalls
MRV Before LP
Dural venous sinus thrombosis (DVST) is the paramount mimicker of IIH. It causes headache, papilloedema, and elevated LP opening pressure — but it is a stroke syndrome requiring anticoagulation, not a benign condition treated with diuretics. An MR Venogram MUST be performed before an LP is used to formally diagnose IIH.
Section 4
Evidence Appraisal
Primary Reference
Diagnostic criteria for idiopathic intracranial hypertension
Friedman DI et al. • Neurology. 2002;59(10):1492-5
