Idiopathic intracranial hypertension (IIH) is a condition of significant morbidity and rising prevalence. It typically affects young people living with obesity, mostly women of reproductive age, and can present with headaches, visual abnormalities, tinnitus and cognitive dysfunction. Raised intracranial pressure without a secondary identified cause remains a key diagnostic feature of this condition, however, the underlying pathophysiological mechanisms that drive this increase are poorly understood. Previous theories have focused on cerebrospinal fluid (CSF) hypersecretion or impaired reabsorption, however, the recent characterisation of the glymphatic system in many other neurological conditions necessitates a re-evaluation of these hypotheses. Further, the impact of metabolic dysfunction and hormonal dysregulation in this population group must also be considered. Given the emerging evidence, it is likely that IIH is triggered by the interaction of multiple aetiological factors that ultimately results in the disruption of CSF dynamics. This review aims to provide a comprehensive update on the current theories regarding the pathogenesis of IIH.

中文翻译：

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了解特发性颅内高压 (IIH) 的病理生理学：最新进展回顾

特发性颅内高压（IIH）是一种发病率很高且患病率不断上升的疾病。它通常影响肥胖的年轻人，其中大多数是育龄妇女，并可能出现头痛、视觉异常、耳鸣和认知功能障碍。在没有明确继发原因的情况下颅内压升高仍然是这种情况的一个关键诊断特征，然而，驱动这种升高的潜在病理生理机制却知之甚少。先前的理论主要集中在脑脊液 (CSF) 分泌过多或重吸收受损，然而，最近在许多其他神经系统疾病中对类淋巴系统的表征需要重新评估这些假设。此外，还必须考虑该人群代谢功能障碍和激素失调的影响。鉴于不断出现的证据，IIH 很可能是由多种病因因素的相互作用引发的，最终导致脑脊液动力学的破坏。本综述旨在对当前 IIH 发病机制的理论进行全面更新。