Exploring the lived experience of economic insecurity and health among people accessing charity-run food provision services in Bristol, UK.

Primary intracranial hypertension (idiopathic intracranial hypertension, pseudotumor cerebri) was first described by Quincke in 1897 as “meningitis serosa.” The same clinical syndrome became known as pseudotumor cerebri beginning in 1904 and as idiopathic intracranial hypertension in the 1980s., Both terms are still frequently used, though confusion between them warrants discussion. Some prefer the broader designation of “pseudotumor cerebri syndrome” (PTCS), which includes the designation of idiopathic if no cause is found., We prefer the terms “primary intracranial hypertension” (PIH) and “secondary intracranial hypertension” (SIH) and use these henceforth., PIH is diagnosed in cases without a clear causative condition, though a patient may have risk factors including obesity, female gender, and post‐pubertal status. SIH is diagnosed when intracranial hypertension (IH) is the direct result of other conditions, such as medications or cerebral sinus venous thrombosis. The threshold opening pressure that defines intracranial hypertension has also changed, most recently through a proposed higher cutoff of 28 cm HO., , Avery et al. did find small correlations with higher opening pressures in deeply sedated and obese patients, suggesting 25 cm HO as the cutoff for those not meeting these criteria. The cutoff of 28 cm HO has been incorporated into the PTCS criteria, but there remains debate as their study population included individuals with demyelinating disorders in the normal cohort., Pediatric studies have shown higher opening pressures among patients with demyelinating conditions., , Lee et al. found those with demyelinating disease had a higher mean opening pressure compared with the entire cohort (21.5 cm HO vs. 20.3 cm HO). Narula et al. reexamined their initial cohort used to suggest the cutoff of 28 cm HO and documented that 28% of patients with demyelination had elevated opening pressures using this cutoff. Morgan‐Followell and Aylward compared a series of patients with demyelinating disease to those with PIH and found no statistical difference in opening pressure between the two groups. As expected, PIH patients had a statistically significant higher body mass index (BMI), and the demyelinating group had a higher mean cerebrospinal fluid (CSF) white blood cell count. Due to these concerns, some practitioners still use the older accepted cutoffs of 18 cm HO for patients under 8 years of age and 25 cm HO for patients 8 years and older., , As there is nuance in the definition of IH, there is variation in the epidemiologic profile as well. The reported annual incidence in the United States is 0.63 or 0.32 per 100 000 children for PIH and SIH, respectively. Ghaffari‐Rafi et al. queried a pediatric inpatient admissions directory and found a median incidence of 0.89 over a 17‐year period. Internationally the annual incidence in Nova Scotia and Prince Edward Island is 0.6–0.9., In Germany the incidence is estimated to be 0.47, though this is based on a country‐wide survey and appears to include both PIH and “potentially causal” cases. In the United Kingdom and Ireland the annual incidence is 0.71, though narrowing the sample to obese 12–15‐year‐old males and females increases the respective incidences to 4.18 and 10.7.