EC Neurology

Aim: Idiopathic intracranial hypertension is presented by headache and visual impairment and frequently seen in women of repro- ductive age. The present study aimed to evaluate the recovery rates of idiopathic intracranial hypertension symptoms and patient compliance with weight control and treatment during the follow-up period.

Materials and Methods: The files of 106 patients who were diagnosed as having idiopathic intracranial hypertension were exam- ined. Idiopathic intracranial hypertension symptoms, body mass index, fundus examinations, cerebrospinal fluid opening pressure, and cranial imaging findings were obtained from their files. Patients who accepted a phone call were questioned about their current symptoms, body mass index, and treatment of idiopathic intracranial hypertension.

Results: Forty-one patients (37 females and four males) with a mean age of 35 years were included in the study. The mean time be- tween the patients’ symptom onset and hospitalization was 11.5 months (range, 3 days - 10 years). The mean follow-up period of the patients was 3.25 (range, 1 - 10) years and headache in 15 (36.5%) patients and visual symptoms in seven (17%) patients continued. It was observed that the average body mass index of the patients showed a minimal decrease from 32.6 kg/m2 to 31.2 kg/m2. Ten patients continued the drug treatment and 31 patients stopped the treatment within an average of 2.5 years. Eighteen patients left the follow-up voluntarily.

Conclusion: Idiopathic intracranial hypertension requires regular follow-up due to the risk of recurrence, and it was observed that our patients’ compliance with treatment and outpatient follow-up was low. However, despite this, only three patients developed permanent vision loss. This indicates that the prognosis of IIH may be better than expected, even in patients with low treatment compliance in the long term.

Keywords: Idiopathic Intracranial Hypertension; Headache; Obesity; Treatment

1. Wall M. “Update on Idiopathic Intracranial Hypertension”. Neurologic Clinics 35 (2017): 45-57.
2. Sundholm A., et al. “Infectious and inflammatory disorders might increase the risk of developing idiopathic intracranial hypertension - a national case-control study”. Cephalalgia 40 (2020): 1084-1094.
3. Bruce BB., et al. “Idiopathic intracranial hypertension in men”. Neurology 72 (2009): 304-309.
4. Andrews LE., et al. “Idiopathic intracranial hypertension and obesity”. Hormone Research Paediatrics 81 (2014): 217-225.
5. Subramaniam S and Fletcher WA. “Obesity and Weight Loss in Idiopathic Intracranial Hypertension”. Journal of Neuro-Ophthalmology 37 (2017): 197-205.
6. Friedman DI., et al. “Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children”. Neurology 81 (2013): 1159-1165.
7. Wall M., et al. “The idiopathic intracranial hypertension treatment trial clinical profile at baseline”. JAMA Neurology 71 (2014): 693-701.
8. Yri HM., et al. “The course of headache in idiopathic intracranial hypertension: A 12-month prospective follow-up study”. European Journal of Neurology 21 (2014): 1458-1464.
9. Toscano S., et al. “An update on idiopathic intracranial hypertension in adults: a look at pathophysiology, diagnostic approach and management”. Journal of Neurology (2020).
10. Rigi M., et al. “Papilledema: Epidemiology, etiology, and clinical management”. Eye Brain 7 (2015): 47-57.
11. Wall M., et al. “Threshold static automated perimetry of the full visual field in idiopathic intracranial hypertension”. Investigative Ophthalmology Visual Science 60 (2019): 1898-1905.
12. Daniels AB., et al. “Profiles of Obesity, Weight Gain, and Quality of Life in Idiopathic Intracranial Hypertension (Pseudotumor Cere-bri)”. American Journal of Ophthalmology 143 (2007): 635-641.
13. Szewka AJ., et al. “Idiopathic intracranial hypertension: Relation between obesity and visual outcomes”. Journal of Neuro-Ophthalmol-ogy 33 (2013): 4-8.
14. Appel LJ., et al. “Comparative effectiveness of weight-loss interventions in clinical practice”. The New England Journal of Medicine 365 (2011): 1959-1968.
15. Ball AK and Clarke CE. “Idiopathic intracranial hypertension”. The Lancet Neurology 5 (2006): 433-442.
16. Mallery RM., et al. “Utility of magnetic resonance imaging features for improving the diagnosis of idiopathic intracranial hypertension without papilledema”. Journal of Neuro-Ophthalmology 39 (2019): 299-307.
17. Agid R., et al. “Idiopathic intracranial hypertension: The validity of cross-sectional neuroimaging signs”. Neuroradiology 48 (2006): 521-527.
18. Bono F., et al. “The upper limit of normal CSF opening pressure is related to bilateral transverse sinus stenosis in headache sufferers”. Cephalalgia 30 (2010): 145-151.