What Does an Intracranial Hypertension Diagnosis Mean for Me?

February 21st, 2018

Many women have been diagnosed with intracranial hypertension (IH) following their implantation of the intrauterine device (IUD), Mirena. In fact, medical literature shows that implantation of Mirena significantly increases the user’s risk of developing IH. In case you are unfamiliar, intracranial hypertension is pressure felt within the skull due to a buildup of cerebral spinal fluid (CSF) in the spaces that surround the brain and spinal column. Symptoms indicative of IH include, but are not limited to: severe headaches; changes in peripheral vision; papilledema; short-term memory loss; nausea; and vomiting.

Women experiencing these symptoms are typically referred to a neuro ophthalmologist and/or a neurologist for further testing and evaluation. Unfortunately, IH can only be definitively diagnosed by way of a lumbar puncture, (or spinal tap). During a lumbar puncture to test for IH, the doctor inserts a needle, connected to a manometer, into the spinal canal via the lower back. Upon insertion of the needle, the manometer measures the pressure of the CSF that is circulating around the brain and spinal cord. An opening pressure greater than 25 is suggestive of intracranial hypertension. IH is a very serious condition and if treatment is delayed, permanent vision loss or neurologic damage can occur. As such, if you or a loved one has Mirena and suffer from the above symptoms, IH could very well be the cause and medical treatment should be sought promptly.

Once diagnosed with IH, you may be wondering what now, or what does this mean for me going forward? Ultimately, the goal for IH patients is to decrease the amount of CSF within the body, which will hopefully help to alleviate or reduce the related symptoms. Available treatment options for IH will depend on the severity of your condition and your doctor’s recommendations. Generally speaking, however, treatments for IH are often multifaceted, and range from conservative (medications and symptom monitoring) to significantly invasive (brain surgery).

Conservative treatment for IH often begins with medication. The medications prescribed by doctors to treat their IH patients belong to a class of drugs called Carbonic Anhydrase Inhibitors (CAIs), which work with the body to decrease the production of CSF. The most commonly prescribed CAIs include: Diamox; Neptazane; and Lasix. In addition, some providers may recommend over-the-counter potassium supplements, which also acts as a natural CAI, and helps to reduce the production of CSF.

Ironically, the test used to diagnose IH can also work as treatment for the disorder. Lumbar punctures, while much more invasive than drug therapy, also help to decrease the body’s level of CSF. This is because the CSF that is removed during a lumbar puncture also helps to reduce the body’s volume of CSF, which in turn can help with symptom reduction. However, if your symptoms cannot be controlled by way of medication and/or lumbar puncture(s), surgery is most likely the next step in treatment.

There are a few different surgical options to consider when treating IH caused by Mirena. One of those surgeries, an optic nerve fenestration (optic nerve sheath decompression), manually drains CSF from behind the eye(s) and is performed in patients whose symptoms include loss of peripheral vision. Another surgical option available to IH patients is neurological shunt placement. Shunts may be used to prevent vision loss, as well as to treat headaches unresponsive to medication. A neurosurgical shunt is a surgically-implanted catheter that is used to decrease intracranial pressure by draining CSF into another area of the body, such as the abdomen, chest, or heart, where it can more readily be absorbed.

It is important to keep in mind that there is no “perfect” or uniform treatment for IH, especially since every person’s symptoms are different. While surgery and/or medication can help, they can also lead to their own host of serious side effects, repeat surgeries, and/or life-threatening complications. To make an informed decision, it is always best to discuss all treatment options, as well as the associated risks and benefits related thereto, with your doctor(s).

Regrettably, many women who have received Mirena are unaware that their symptoms are related to the device, or that they could be indicative of a very serious underlying condition. Currently, The Yost Legal Group is investigating hundreds of women’s claims that Mirena caused their development of intracranial hypertension. Point blank, the manufacturer of Mirena, Bayer Pharmaceuticals, failed to do its job, as it did not properly warn women or their doctors of the serious side effects associated with the use of its device.  Ultimately, it is through litigating these cases that we aim to spread awareness to these issues and hold Bayer accountable for the harm it has caused. If you suspect that you or someone you know has developed intracranial hypertension, following use of Mirena, The Yost Legal Group may be able to help. Our team of experienced legal professionals is here to offer you free, individual consultation. Call The Yost Legal Group at 1-800-YOST-LAW.

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