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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.<\/jats:p>","DOI":"10.1136\/jnnp-2023-332222","type":"journal-article","created":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T17:22:04Z","timestamp":1696526524000},"page":"jnnp-2023-332222","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":31,"title":["Understanding the pathophysiology of idiopathic intracranial hypertension (IIH): a review of recent developments"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6860-4378","authenticated-orcid":false,"given":"Blake D","family":"Colman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederique","family":"Boonstra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minh NL","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subahari","family":"Raviskanthan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Sumithran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8543-7767","authenticated-orcid":false,"given":"Elspeth J","family":"Hutton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Fielding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4278-7003","authenticated-orcid":false,"given":"Anneke","family":"van der Walt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,10,5]]},"reference":[{"key":"2023100510201715000_jnnp-2023-332222v1.1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2015-311302"},{"key":"2023100510201715000_jnnp-2023-332222v1.2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a55f17"},{"key":"2023100510201715000_jnnp-2023-332222v1.3","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1038\/s41433-018-0238-5","article-title":"The expanding burden of idiopathic intracranial hypertension","volume":"33","author":"Mollan","year":"2019","journal-title":"Eye (Lond)"},{"key":"2023100510201715000_jnnp-2023-332222v1.4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/IIO.0b013e3182aabf11","article-title":"Epidemiology and risk factors for idiopathic intracranial hypertension","volume":"54","author":"Chen","year":"2014","journal-title":"Int Ophthalmol Clin"},{"key":"2023100510201715000_jnnp-2023-332222v1.5","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000333254.84120.f5"},{"key":"2023100510201715000_jnnp-2023-332222v1.6","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13739"},{"key":"2023100510201715000_jnnp-2023-332222v1.7","doi-asserted-by":"crossref","first-page":"e1251","DOI":"10.1212\/WNL.0000000000011463","article-title":"Incidence, prevalence and Healthcare outcomes in idiopathic intracranial hypertension: a population study","volume":"96","author":"Miah","year":"2021","journal-title":"Neurology"},{"key":"2023100510201715000_jnnp-2023-332222v1.8","doi-asserted-by":"crossref","unstructured":"Ghaffari-Rafi A , Mehdizadeh R , Ko AWK , et al . 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