Question about elevated intracranial pressure

[problemmatic]

Does the absence of papilledema on an eye exam definitively rule out the possibility of idiopathic elevated intracranial pressure?

[CCF-Neuro-M.D.-PW]

Not altogether, in very early increases in intracranial pressure can be normal, and in milder levels of increased pressure it may be normal - the exact threshold I'm not sure. But absence would  suggest that there is not a serious elevation of pressure over time. The amount of visual field loss in idiopathic elevated intracranial pressure is proportional to teh severity of papilledema/optic nerve pressure, so with normal optic discs, visual loss should be minimal

[problemmatic]

I should have added, if there is no reason to suspect increased intracranial pressure, can a feeling of just tremendous and relentless pressure mostly in the forehead as well as pain really be caused by a primary headache as opposed to being secondary to some pathology?