Which medication is associated with intracranial hypertension (pseudotumor cerebri)?

• A. Oral contraceptives
• B. Indomethacin
• C. Acetaminophen
• D. Pseudoephedrine

Answer: (A)

Pseudotumor cerebri, or idiopathic intracranial hypertension, involves elevated intracranial pressure without a mass lesion and often presents with headaches and papilledema. Certain medications can precipitate this condition by affecting cerebrospinal fluid dynamics or venous outflow. Among the options, estrogen-containing oral contraceptives have been linked to intracranial hypertension in some cases, likely through hormonal effects that influence venous outflow or CSF absorption in susceptible individuals. The other drugs listed do not have a well-established association with this condition. So the oral contraceptives are the best answer. In clinical practice, if such a drug is suspected, consider discontinuation and evaluate with imaging and lumbar puncture, then manage with measures to reduce CSF production and address modifiable risk factors.