Headache attributed to idiopathic intracranial hypertension (IIH)
A. Progressive headache with at least 1 of the following characteristics and fulfilling criteria C-D:
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Daily occurrence
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Diffuse and/or constant (non-pulsating) pain
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Aggravated by coughing or straining
B. Intracranial hypertension fulfilling the following criteria:
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Alert patient with neurological examination that either is normal or demonstrates any of the following abnormalities:
a) Papilloedema
b) Enlarged blind spot
c) Visual field defect (progressive if untreated)
d) Sixth nerve palsy
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Increased CSF pressure (>200 mm H2O in the nonobese, >250 mm H2O in the obese) measured by lumbar puncture in the recumbent position or by epidural or intraventricular pressure monitoring
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Normal CSF chemistry (low CSF protein is acceptable) and cellularity
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Intracranial diseases (including venous sinus thrombosis) ruled out by appropriate investigations
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No metabolic, toxic or hormonal cause of intracranial hypertension
C. Headache develops in close temporal relation to increased intracranial pressure
D. Headache improves after withdrawal of CSF to reduce pressure to 120-170 mm H2O and resolves within 72 hours of persistent normalisation of intracranial pressure
Headache attributed to increased intracranial pressure or hydrocephalus caused by neoplasm
A. Diffuse non-pulsating headache with at least 1 of the following characteristics and fulfilling criteria C-D:
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Associated with nausea and/or vomiting
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Worsened by physical activity and/or manoeuvres known to increase intracranial pressure (such as Valsalva manoeuvre, coughing or sneezing)
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Occurring in attack-like episodes
B. Space-occupying intracranial tumour* demonstrated by CT or MRI and causing hydrocephalus
C. Headache develops and/or deteriorates in close temporal relation to the hydrocephalus
D. Headache improves within 7 days after surgical removal or volume-reduction of tumour
*including colloid cyst of the IIIrd ventricle.
Headache attributed directly to neoplasm
A. Headache with at least 1 of the following characteristics and fulfilling criteria C-D:
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progressive
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localised
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orse in the morning
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aggravated by coughing or bending forward
B. Intracranial neoplasm shown by imaging
C. Headache develops in temporal (and usually spatial) relation to the neoplasm
D. Headache resolves within 7 days after surgical removal or volume-reduction of neoplasm or treatment with corticosteroids