1. Papilledema

2. Normal neurologic examination except for sixth nerve palsy

3. Normal brain parenchyma with no hydrocephalus, mass, structural lesion, or abnormal meningeal enhancement on MRI; venous imaging needed to exclude cerebral venous sinus thrombosis

4. Normal CSF analysis

5. Elevated lumbar puncture opening pressure ≥25 cm CSF

Idiopathic intracranial hypertension without papilledema can be diagnosed if criteria 2-5 are met and the patient has unilateral or bilateral cranial nerve sixth palsy.

In the absence of papilledema or sixth nerve palsy, idiopathic intracranial hypertension without papilledema can be suggested but not confirmed if criteria 2-5 are satisfied and there are ≥3 neuroimaging findings suggestive of increased intracranial pressure:

1) Empty sella

2) Flattening of the posterior aspect of the globe

3) Distension of the perioptic subarachnoid space with or without optic nerve tortuosity

4) Transverse venous sinus stenosis