This in itself is often an indication for surgical intervention. As most people with BIH appear perfectly normal, they often do not receive the recognition they deserve. BIH can be very disabling. Headache can be constant, thus disturbing normal sleep patterns. Depression is not uncommon.
Management is variable.
Some people do very well on a regime of diuretics and steroids but must be monitored symptomatically, and by CSF pressure measurement to protect the eye sight. Some people need repeated lumbar punctures to remove excess CSF, or the excess CSF may need to be diverted by means of a surgically inserted shunt. In theory, a lumbar peritoneal shunt is the shunt of choice. In practice, the patient may undergo frequent shunt revision, including changing to ventriculo-peritoneal shunt, or insertion of a lumbar reservoir. Once a shunt is in place, the patient is at risk of those complications associated with shunting - for whatever reason.