The syndrome of increased intracranial pressure without localizing signs: a reappraisal.

One hundred adult patients with headache, papilledema, and no localizing signs were evaluated prospectively and followed for up to 54 months. No patient with this syndrome who had a normal mental status, negative brain scan, and normal electroencephalogram was found subsequently to harbor a mass lesion. Benign intracranial hypertension was the final diagnosis in 71 percent of the patients studied. Lumbar puncture was a safe and helpful diagnostic procedure, and in no case was subsequent neurologic deterioration noted.