IdiopathicThe term idiopathic is used when there is no detectable reason for something. intracranial hypertension (IIH) is a serious and disabling condition that requires close management by an experienced physician. In conjunction with medical adherence, there are ways to help relieve certain symptoms associated with IIH using remedies backed by scientifically proven data.

Headaches

Headache is the most common symptom encountered in women with IIH, and is reported in almost 98% of sufferers¹. In fact, most women with IIH concurrently have a diagnosis of chronic migraine². Symptom relief for any type of headache includes:

Staying hydrated. Water is essential to the body, especially the brain. Dehydration is the number one cause of a headache, yet is reversible by ingesting an adequate amount of water each day³. Each individual’s daily requirement for water varies day-to-day depending on activity level, environmental conditions, differences in metabolism, and current health status. The recommended daily intake of water a day for women is 2.7 liters (about half of a gallon of water) and for men, 3.7 liters⁴. Drinking a sufficient amount of water each day is a straightforward, accessible, affordable, and proven way to improve headache symptoms⁵.

Get plenty of sleep. Difficulty falling asleep, remaining asleep throughout the night, and tiredness throughout the day area contribute to headache symptoms⁶. During sleep cycles, your body and brain are able rest and restore itself in preparation for the times you are awake. Attention, memory, mood, reaction, and thought are important brain functions that are affected by the amount of sleep you get a day.⁷ By getting 7 hours of sleep a day one can improve the number headache-free days⁶.

Limit or eliminate alcohol use. Alcohol contains properties that can increase urine output (a source of dehydration) and cause dilation of the blood vessels (causing a decrease in blood pressure), both of which are documented causes of a headache⁸. Research reports as many as 50% of people who suffer from migraines attribute any form of alcohol a reason for their headache⁸. Avoidance of alcohol alone can prevent headache symptoms in a majority of people.

Avoid exposure to conditions that trigger a headache. Loud noise, strong smells (cigarette smoke, cleaning supplies, and perfumes)⁹ and bright lights are reported causes of headache. Foods high in biogenic amines such as cheese, red wine, fermented vegetables, fish, and cured meats can also trigger a headache⁸. Take time to sit in a dark, quiet place, use a cold compress over affected areas, and get some rest. As you get a sense of your own triggers, making an effort to avoid them will help achieve headache-free days.

Over-the-counter medication. Pain reducers that are available without a prescription are: acetaminophen, ibuprofen, and aspirin. There are also combination drugs such as Excedrin that contain aspirin, acetaminophen, and caffeine all in one tablet. Every drug bears its own risks and benefits and may even be contraindicated in certain populations. For example, acetaminophen (Tylenol) can cause liver damage or can worsen liver issues if taken for too long or not according to the dosing guide. Non-steroidal anti-inflammatory drugs (NSAIDs) are an effective pain reducers that are associated with conditions such as: peptic ulcers, kidney failure, and high blood pressure. Meaning, if you have any of these medical issues, it is best to avoid taking NSAIDs. Aspirin (ASA) is commonly used to treat fever, pain, and inflammation but carries a bleeding risk. When trying to decide which medication is best to treat your headache, know its side effects and how it can affect any other health conditions you may have¹⁰.

Caffeine. This stimulant can be found in coffee, tea, chocolate, energy drinks, and supplements. Interestingly, it can help enhance the analgesic effects of the over-the-counter medications listed above¹¹. One study found that 130 mg of caffeine (equivalent to about 1 latte) improved headache symptoms¹¹. Caution is advised in its use as too much caffeine a day and abruptly discontinuing caffeine in one with a high tolerance can induce a headache.

Nausea

The urge to vomit is a defense mechanism that is activated when the body encounters something harmful or toxic. Specific pathways in the brain can induce nausea, especially when it detects high pressure in the brain as in IIH. Nausea is a symptom that often is accompanied by a headache and some of the ways to relieve one can help resolve the other. Here is a list of ways to improve this distressing symptom with evidence-based medicine.

Ginger. This flowering plant has been used as a naturopathic medicine for centuries. Some of the properties in ginger root have been shown to improve nausea and headaches¹². The most effective dose to prevent nausea was best observed at 0.5mg-11.0 mg of ginger a day¹².

Bland diet. Eating foods that are low in spice, low in fiber, soft in texture and cooked are easier for the stomach to digest. Eating smaller, frequent meals is also helpful as nausea and vomiting are closely related¹³.

Acupuncture and acupressure. These are both a form of complementary medicine, meaning it is useful in conjunction with scientifically-proven medicine. Either a needle or pressure is placed on the inner part of your wrist to stimulate the central nervous system resulting in an anti-nausea effect¹⁴.

References

Ball A, Clarke C. IdiopathicThe term idiopathic is used when there is no detectable reason for something. intracranial hypertension. The Lancet Neurology. May 2006;5(5):433-442.
Mollan S, Hoffmann J, Sinclair A. Advances in the understanding of headache in idiopathic intracranial hypertension. Curr Opin Neurol. February 2019;32(1):92-98.
Khorsha F, Mirzabavaei A, Togha M, et al. Association of drinking water and migraine headache severity. Journal of Clinical Neuroscience. July 2020. 77;81-84. The U.S. National Academies of Sciences, Engineering, and Medicine
National Academies Science Engineering Medicine. Dietary Reference and Intake for Electrolytes and Water. 2005. Accessed June 1, 2022. https://www.nationalacademies.org/our-work/dietary-reference-intakes-for-electrolytes-and-water
Popkin B, D’Anci K, Rosenberg I. Water, hydration, and health. Nutrition Reviews. August 2010;68(8):439-458
Kelman L, Rains J. Headache and sleep: examination of sleep patterns and complaints in a large clinical sample of migraineurs. Headache. July-August 2005;45(7):904-910.
Eugene A, Masiak J. The Neuroprotective Aspects of Sleep. MEDtube Sci. March 2015;3(1):35-40.
Wober C, Wober-Bingol C. Triggers of migraine and tension-type headache. Headache. September 3, 2010;97:161-172
Marmore A, Spaienza G, Vinicius de Oliveira G, et al. Odors as triggering and worsening factors for migraine in men. Arq Neuropsiquiatr. 2011;69(2-B):324-327
Duda K. Is There Any Difference Between OTC Pain Relievers? The differences between Tylenol, Aleve, Advil, and Aspirin. verywellhealth. Updated December 10, 2021. Accessed May 20, 2022. https://www.verywellhealth.com/what-is-the-difference-between-motrin-and-advil-770459
Lipton R, Diener H, Robbins M, et al. Caffeine in the management of patients with headache. J Headache Pain. October 24, 2017;18(1):107
Ryan J, Heckler C, Roscoe J, et al. Ginger (ZSingiber officinale) reduces acute chemotherapy-induced nausea: a URCC CCOP study of 576 patients. Support Care Cancer. August 5, 2011;20:1479-1489.
NHS. The Leeds Teaching Hospital. Bland diet. Published August 2021. Accessed May 15, 2022. https://flipbooks.leedsth.nhs.uk/LN005070.pdf
Stott A. Examining the efficacy of stimulating the PC6 wrist acupuncture point for preventing postoperative nausea and vomiting: A Cochrane review summary. International Journal of Nursing Studies. 2016; 64:139-141.

Edith Ruiz, PA-C

Edith Ruiz, PA-C is a certified physician assistant with over 14 years of clinical experience, including the care of neurological surgery and bariatric surgery patients. Additionally, she has several years of experience as a medical writer for healthcare companies to help connect patients to medical information.

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