scholarly journals E-003 Quality of life, need for retreatment, and the re-equilibration effect after venous sinus stenting for idiopathic intracranial hypertension

2020 ◽  
Author(s):  
R Garner ◽  
J Aldridge ◽  
S Wolfe ◽  
K Fargen
Keyword(s):  
Quality Of Life ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Venous Sinus

Quality of life, need for retreatment, and the re-equilibration phenomenon after venous sinus stenting for idiopathic intracranial hypertension

2020 ◽  
Vol 13 (1) ◽  
pp. 79-85 ◽  
Author(s):  
Rebecca M Garner ◽  
Jennifer Bernhardt Aldridge ◽  
Stacey Q Wolfe ◽  
Kyle M Fargen
Keyword(s):  
Quality Of Life ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Surgical Intervention ◽  
Venous Sinus ◽  
Sinus Stenosis ◽  
Cerebrospinal Fluid Shunting

BackgroundLong term failure rates after venous sinus stenting (VSS) for idiopathic intracranial hypertension (IIH) are poorly understood.MethodsRetrospective analysis was performed on a prospectively-maintained single center database to identify patients with medically refractory IIH who underwent VSS. Patients with persistent or severe recurrent symptoms after VSS undergo lumbar puncture (LP), therefore LP serves as a marker for treatment failure.Results81 patients underwent VSS with a mean follow-up of 10 months; 44 (54.3%) patients underwent LP after VSS due to persistent or recurrent symptoms at a mean of 12 months (median 7, range 2–43). There was a mean decrease in opening pressure (OP) on LP from pre- to post-VSS of 9.1 cm H2O (median 9.5). Overall, a total of 21 (25.9%) patients underwent further surgical intervention following VSS, including five who underwent repeat VSS (6.2% of total) and 18 who underwent cerebrospinal fluid shunting (22.2% of total). There was a non-significant (p=0.18) but overall increase in quality of life scores from pre-stenting (61.2) to last follow-up (71.2), and a significant decrease in Headache Impact Test-6 (HIT-6) scores (p=0.03) with mean pre-stenting and last follow-up scores of 62.7 and 55.8, respectively.ConclusionsVSS is an effective treatment for venous sinus stenosis in IIH; however, this study found higher rates of symptomatic recurrence and need for further surgical intervention (26%) than previously reported in the literature. Recurrence of symptoms occurred at a median of 7 months, even though OP remained lower at follow-up LP, suggestive of a re-equilibration phenomenon.

scholarly journals Intracranial Pressure Directly Predicts Headache Morbidity in Idiopathic Intracranial Hypertension

2021 ◽  
Author(s):  
Susan Mollan ◽  
Benjamin Wakerley ◽  
Zerin Alimajstorovic ◽  
James Mitchell ◽  
Ryan Ottridge ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Mass Index ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Body Mass ◽  
Idiopathic Intracranial Hypertension ◽  
Positive Association ◽  
Headache Severity ◽  
Cutaneous Allodynia

Abstract Objective: Headache is the predominant disabler in idiopathic intracranial hypertension (IIH). The aim was to characterise headache and investigate the association with intracranial pressure.Methods: IIH:WT was a randomised controlled parallel group multicentre trial in the United Kingdom investigating weight management methods in IIH. Participants with active IIH (evidenced by papilloedema) and a body mass index (BMI) ≥35kg/m2 were recruited. At baseline, 12 months and 24 months headache characteristics and quality of life outcome measures were collected and lumbar puncture measurements were performed.Results: Sixty-six women with active IIH were included with a mean age of 32.0 years (SD ± 7.8), and mean body mass index of 43.9 ± 7.0 kg/m2. The headache phenotype was migraine-like in 86%. Headache severity correlated with ICP at baseline (r=0.285; p=0.024); change in headache severity and monthly headache days correlated with change in ICP at 12 months (r=0.454, p=0.001 and r=0.419, p=0.002 respectively). Cutaneous allodynia was significantly correlated with ICP at 12 months. (r=0.479, p<0.001). Boot strap analysis noted a positive association between ICP at 12 and 24 months and enabled prediction of both change in headache severity and monthly headache days. ICP was associated with significant improvements in quality of life (SF-36).Conclusions: We demonstrate a positive relationship between ICP and headache and cutaneous allodynia, which has not been previously reported in IIH. Those with the greatest reduction in ICP over 12 months had the greatest reduction in headache frequency and severity; this was associated with improvement of quality of life measures.Classification of evidence: This work provides Class IIa evidence of the association of raised intracranial pressure and headache. ClinicalTrials.gov number, NCT02124486.

scholarly journals Emergency department utilization among individuals with idiopathic intracranial hypertension

2019 ◽  
Vol 32 (1) ◽  
pp. 152-163
Author(s):  
Sean Murphy ◽  
Daniel L. Friesner ◽  
Robert Rosenman ◽  
Carin S. Waslo ◽  
Johnathan Au ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Private Insurance ◽  
Symptom Relief ◽  
Emergency Department Utilization ◽  
Life Questionnaire ◽  
Content Type ◽  
Shunt Procedure

Purpose Idiopathic intracranial hypertension (IIH) can be a debilitating disorder that is difficult to identify and treat. Failure to adequately manage IIH symptoms may force patients to present at emergency departments (EDs) seeking symptom relief. The purpose of this paper is to empirically characterize ED use by previously diagnosed IIH patients. Design/methodology/approach Patients diagnosed with IIH, and who registered with the Intracranial Hypertension Registry by 2014, were solicited for study inclusion. A survey was designed to elicit ED use during the period 2010–2012. Information on demographic and socioeconomic characteristics, IIH signs and symptoms, time since diagnosis, perspectives of ED use and quality of life was collected. Quality of life was assessed using an adaptation of the Migraine-Specific Quality of Life Questionnaire. Data were analyzed using descriptive statistics and nonparametric hypothesis tests. Findings In total, 39 percent of IIH patients used emergency services over the study period; those that did used the services intensely. These patients were more likely to be non-white, live in households making less than $25,000 annually, have public insurance and have received a diversional shunt procedure. Patients who used the ED were less likely to live in households making $100,000, or more, annually and have private insurance. Participants who used the ED had significantly lower quality-of-life scores, were younger and had been diagnosed with IIH for less time. Originality/value ED staff and outside physicians can utilize the information contained in this study to more effectively recognize the unique circumstances of IIH patients who present at EDs.

Antipsychotic pitfalls: idiopathic intracranial hypertension and antipsychotic-induced weight gain

2020 ◽  
Vol 13 (6) ◽  
pp. e236161 ◽  
Author(s):  
Hirofumi Namiki
Keyword(s):  
Quality Of Life ◽  
Weight Gain ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
First Generation ◽  
Vision Loss ◽  
Blurred Vision ◽  
Poor Vision ◽  
Second Generation Antipsychotics

Idiopathic intracranial hypertension (IIH) is a condition associated with poor vision and headaches that can cause disability and reduced quality of life. The onset of IIH is typically associated with sudden weight gain and obesity, which may be due to first-generation or second-generation antipsychotics. This case involved the use of quetiapine in an obese, 28-year-old woman; she gained significant weight after starting the antipsychotic and later developed headaches and blurred vision. Reducing quetiapine and administering acetazolamide significantly improved her symptoms within 4 weeks. This case reminds physicians to consider IIH as a cause of headache and vision loss in patients who have gained weight after starting or increasing quetiapine.

scholarly journals Quality of life in idiopathic intracranial hypertension at diagnosis: IIH Treatment Trial results

Neurology ◽  
2015 ◽  
Vol 84 (24) ◽  
pp. 2449-2456 ◽  
Author(s):  
K. B. Digre ◽  
B. B. Bruce ◽  
M. P. McDermott ◽  
K. M. Galetta ◽  
L. J. Balcer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Treatment Trial

scholarly journals Intracranial pressure directly predicts headache morbidity in idiopathic intracranial hypertension

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
S. P. Mollan ◽  
B. R. Wakerley ◽  
Z. Alimajstorovic ◽  
J. Mitchell ◽  
R. Ottridge ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Mass Index ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Body Mass ◽  
Idiopathic Intracranial Hypertension ◽  
Link Type ◽  
Headache Severity ◽  
Cutaneous Allodynia

Abstract Objective Headache is the predominant disabler in idiopathic intracranial hypertension (IIH). The aim was to characterise headache and investigate the association with intracranial pressure. Methods IIH:WT was a randomised controlled parallel group multicentre trial in the United Kingdom investigating weight management methods in IIH. Participants with active IIH (evidenced by papilloedema) and a body mass index (BMI) ≥35 kg/m2 were recruited. At baseline, 12 months and 24 months headache characteristics and quality of life outcome measures were collected and lumbar puncture measurements were performed. Results Sixty-six women with active IIH were included with a mean age of 32.0 years (SD ± 7.8), and mean body mass index of 43.9 ± 7.0 kg/m2. The headache phenotype was migraine-like in 90%. Headache severity correlated with ICP at baseline (r = 0.285; p = 0.024); change in headache severity and monthly headache days correlated with change in ICP at 12 months (r = 0.454, p = 0.001 and r = 0.419, p = 0.002 respectively). Cutaneous allodynia was significantly correlated with ICP at 12 months. (r = 0.479, p < 0.001). Boot strap analysis noted a positive association between ICP at 12 and 24 months and enabled prediction of both change in headache severity and monthly headache days. ICP was associated with significant improvements in quality of life (SF-36). Conclusions We demonstrate a positive relationship between ICP and headache and cutaneous allodynia, which has not been previously reported in IIH. Those with the greatest reduction in ICP over 12 months had the greatest reduction in headache frequency and severity; this was associated with improvement of quality of life measures. Trial registration This work provides Class IIa evidence of the association of raised intracranial pressure and headache. ClinicalTrials.gov number, NCT02124486.

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