scholarly journals Incidence of idiopathic intracranial hypertension in Fife

2018 ◽  
Vol 64 (2) ◽  
pp. 62-66 ◽  
Author(s):  
Colin Goudie ◽  
Jennifer Burr ◽  
Andrew Blaikie
Keyword(s):  
Visual Impairment ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Clinical Syndrome ◽  
Common Symptom ◽  
Obesity Epidemic ◽  
Prevalence Of Obesity ◽  
One Year ◽  
High Level ◽  
New Diagnosis

Background and aims Idiopathic intracranial hypertension is a clinical syndrome of intracranial hypertension with normal cerebrospinal fluid in the absence of a mass lesion or hydrocephalus on brain imaging. Headache is the most common symptom of idiopathic intracranial hypertension, and about 10–15% of patients suffer from irreversible visual impairment. Previous estimates of the annual incidence of idiopathic intracranial hypertension vary worldwide from 0.03 to 2.2 per 100,000. The major risk factor implicated in idiopathic intracranial hypertension is body mass. Scotland has one of the worst records for obesity in the developed world, and the prevalence of obesity in Fife is higher than the Scottish average. Our aim was to record the incidence of idiopathic intracranial hypertension in NHS Fife over a one-year period. Methods and results Prospective study including every patient who was seen in the ophthalmology department in NHS Fife with a new diagnosis of idiopathic intracranial hypertension over a one-year period. Thirteen patients were seen with a new diagnosis of idiopathic intracranial hypertension from August 2013 to July 2014 giving an incidence of 3.56 per 100,000. Headache was the most common presenting symptom. Three patients were asymptomatic but were noted to have swollen optic discs during a routine sight test. One patient complained of visual symptoms. All patients were overweight. The mean BMI was 36 (range: 28–49). Conclusion The incidence of idiopathic intracranial hypertension in NHS Fife was significantly higher than previous estimates in the literature. This is probably due to a high level of obesity in Fife. Scotland is in the midst of an obesity epidemic and if this continues we may see increasing levels of idiopathic intracranial hypertension nationally with associated increasing incidence of visual impairment in young adults.

scholarly journals Intracranial hypertension due to spinal cord tumor misdiagnosed as pseudotumor cerebri syndrome: case report

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wanglu Hu ◽  
Chun Wang ◽  
Qun Wu ◽  
Yike Chen ◽  
Wei Gao ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Spinal Cord Tumor ◽  
Tumor Resection ◽  
Pseudotumor Cerebri ◽  
Transverse Sinus ◽  
Pathologic Evaluation ◽  
Spinal Imaging ◽  
One Year

Abstract Background Isolated onset of intracranial hypertension due to spinal cord tumor is rare, thus, easily leading to misdiagnosis and delay in effective treatment. Case presentation Herein, we describe a 45-year-old female patient who manifested isolated symptoms and signs of intracranial hypertension and whose condition was initially diagnosed as idiopathic intracranial hypertension and transverse sinus stenosis. The patient received a stent implantation; however, no improvements were observed. One year later her symptoms exacerbated, and during rehospitalization a spinal imaging examination revealed a lumbar tumor. Pathologic evaluation confirmed schwannoma, and tumor resection significantly improved her symptoms, except for poor vision. Conclusions Space-occupying lesions of the spine should be considered in the differential diagnosis of idiopathic intracranial hypertension, even in the absence of spine-localized signs or symptoms.

scholarly journals IDIOPATHIC INTRACRANIAL HYPERTENSION IN UNIVERSITY HOSPITAL IN SAUDI ARABIA, RETROSPECTIVE STUDY

2021 ◽  
Vol 9 (08) ◽  
pp. 300-305
Author(s):  
Faisal Al-Abass ◽  
◽  
Kawther Hadhiah ◽  
Abdullah Al-Fajri ◽  
Hanan AlHabib. ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Retrospective Study ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
University Hospital ◽  
Hormonal Contraceptives ◽  
Common Symptom ◽  
Blurred Vision ◽  
High Index Of Suspicion ◽  
The University

Background: Idiopathic intracranial hypertension (IIH) is one of headache syndromes that is female predominate and associated with increase intracranial pressure without obvious etiology, it has variable clinical presentation, and it needs high index of suspicion to reach diagnosis even with presence of well-established diagnostic criteria. Visual symptoms, which range from visual obscuration to blindness significantly,affect the outcome of this disease. Unfortunately, there is limited literature about IHH in Middle East and in Saudi Arabia in particular. In this retrospective study, we try to shed the light on pseudo-tumor cerebri in university hospital in Saudi Arabia. Methodology: This is a retrospective study conducted among 105 patients with IIH admitted to the university hospital in Saudi Arabia. Data on age, gender, as well as about symptoms, obesity, medication and surgeries, and CT/MRI results was collected. Results: The mean age of patients was 37.72 years old with standard deviation of 13.48 where 96.2 % of patients were females. Headache is the more common symptom presented by 96.2 % of patients followed with blurred vision and papilledema (85.7 %) and over weight (77.1 %). Considering medications taken by patients because of IIH, we found that main medications was Diamox which prescribed to 96.2 % with mean dose of 942.3 mg. Regarding surgical intervention, 4.8 % had a surgery of VP-shunt and 1.9 % had optic nerve fenestration Conclusion: We concluded that IIH incidence is higher among young women with higher body weight and associated with the use of hormonal contraceptives. The main symptoms of IIH are headache with papilledema and visual disturbances. Acetazolamide is the most common prescribed medication for IIH patients while 6.6 % of patients need surgical procedures.

Unilateral papilledema in idiopathic intracranial hypertension: A rare entity

2020 ◽  
pp. 112067212096904
Author(s):  
Mousumi Banerjee ◽  
Swati Phuljhele Aalok ◽  
Deepti Vibha
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Pseudotumor Cerebri ◽  
Clinical Syndrome ◽  
Unknown Etiology ◽  
Obese Women ◽  
Mechanical Compression ◽  
Childbearing Age ◽  
Diagnostic Challenge ◽  
Rare Presentation

Idiopathic Intracranial Hypertension (IIH), also known as pseudotumor cerebri is a clinical syndrome of unknown etiology, which typically affects young, obese women of childbearing age and is characterized by increased intracranial pressure and bilateral papilledema. Unilateral and highly asymmetrical papilledema is a rare presentation in IIH occurring in less than 4% of patients with definite IIH and can poses a diagnostic challenge for the treating physician as it usually raises the suspicion of localized ocular pathology. As per current consensus, papilledema results in stasis of axoplasmic transport due to mechanical compression, leading to secondary vascular changes of venous dilation and hemorrhage. Given this mechanism, the underlying reasons for unilateral and asymmetrical papilledema remain unclear.

scholarly journals Current Perspectives on Idiopathic Intracranial Hypertension without Papilloedema

Life ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 472
Author(s):  
Susan P. Mollan ◽  
Yu Jeat Chong ◽  
Olivia Grech ◽  
Alex J. Sinclair ◽  
Benjamin R. Wakerley
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Lumbar Puncture ◽  
Idiopathic Intracranial Hypertension ◽  
Pseudotumor Cerebri ◽  
Obesity Epidemic ◽  
Refractory Headache ◽  
Pseudotumor Cerebri Syndrome ◽  
Detailed Search ◽  
Degree Of Association

The pseudotumor cerebri syndrome embraces disorders characterised by raised intracranial pressure, where the commonest symptom is headache (90%). Idiopathic intracranial hypertension without papilloedema (IIHWOP) is increasingly recognised as a source of refractory headache symptoms and resultant neurological disability. Although the majority of patients with IIHWOP are phenotypically similar to those with idiopathic intracranial hypertension (IIH), it remains uncertain as to whether IIHWOP is nosologically distinct from IIH. The incidence, prevalence, and the degree of association with the world-wide obesity epidemic is unknown. Establishing a diagnosis of IIHWOP can be challenging, as often lumbar puncture is not routinely part of the work-up for refractory headaches. There are published diagnostic criteria for IIHWOP; however, some report uncertainty regarding a pathologically acceptable cut off for a raised lumbar puncture opening pressure, which is a key criterion. The literature provides little information to help guide clinicians in managing patients with IIHWOP. Further research is therefore needed to better understand the mechanisms that drive the development of chronic daily headaches and a relationship to intracranial pressure; and indeed, whether such patients would benefit from therapies to lower intracranial pressure. The aim of this narrative review was to perform a detailed search of the scientific literature and provide a summary of historic and current opinion regarding IIHWOP.

scholarly journals Headaches and papilloedema in a pregnant woman with polycystic ovarian syndrome

2011 ◽  
Vol 4 (1) ◽  
pp. 28-29
Author(s):  
Adam Morton
Keyword(s):  
Pregnant Woman ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Polycystic Ovarian Syndrome ◽  
Rare Condition ◽  
Reproductive Age ◽  
Obese Women ◽  
Women Of Reproductive Age ◽  
New Diagnosis ◽  
Ovarian Syndrome

Idiopathic intracranial hypertension (IIH) is a rare condition, its highest incidence being in obese women of reproductive age. A woman with polycystic ovarian syndrome and IIH is presented, a new diagnosis during pregnancy resulting in a change in her management.

scholarly journals Idiopathic intracranial hypertension: a review of diagnosis and management

2021 ◽  
Vol 20 (4) ◽  
pp. 16-20
Author(s):  
Samuel Jeffery ◽  
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Surgical Interventions ◽  
Optic Nerve Sheath Fenestration ◽  
Nerve Sheath ◽  
Prevalence Of Obesity ◽  
Csf Diversion ◽  
Disease Modifying ◽  
Disease Modifying Treatment

With the increasing prevalence of obesity, the incidence of idiopathic intracranial hypertension (IIH) is rising. Headache and threat to vision are the predominant features and the principal cause of morbidity and reduced quality of life. Identification of papilloedema must prompt urgent investigation to exclude any underlying cause and management should be multi-disciplinary, focusing on protecting vision and reducing headache burden. Weight loss is the most effective and only disease modifying treatment for IIH but surgical interventions may need to be considered in some patients. Whilst optic nerve sheath fenestration and CSF diversion have established roles in protecting vision, there is increasing interest in venous sinus stenting and bariatric surgery as additional interventions that may have efficacy in the treatment of this condition.

Is cerebrospinal fluid shunting in idiopathic intracranial hypertension worthwhile? A 10-year review

Cephalalgia ◽  
2011 ◽  
Vol 31 (16) ◽  
pp. 1627-1633 ◽  
Author(s):  
Alexandra J Sinclair ◽  
Sarin Kuruvath ◽  
Diptasri Sen ◽  
Peter G Nightingale ◽  
Michael A Burdon ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Visual Acuity ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Low Pressure ◽  
Shunt Revision ◽  
Common Symptom ◽  
Csf Diversion ◽  
Low Pressure Headache ◽  
Pressure Headache

Background: The role of cerebrospinal fluid (CSF) diversion in treating idiopathic intracranial hypertension (IIH) is disputed. Method: We conducted a 10-year, retrospective case note review to evaluate the effects of CSF diversion in IIH. Symptoms, signs and details of shunt type, complications and revisions were documented at baseline, 6, 12 and 24 months post-operatively. Results: Fifty-three IIH patients were shunted [predominantly lumboperitoneal (92%)]. The most common symptom pre-surgery was headache (96%). Post-operatively, significantly fewer patients experienced declining vision and visual acuity improved at 6 ( p = 0.001) and 12 months ( p = 0.016). Headache continued in 68% at 6 months, 77% at 12 months and 79% at 2 years post-operatively. Additionally, post-operative low-pressure headache occurred in 28%. Shunt revision occurred in 51% of patients, with 30% requiring multiple revisions. Conclusion: We conclude that CSF diversion reduces visual decline and improves visual acuity. Unfortunately, headache remained in the majority of patients and low-pressure headache frequently complicated surgery. Over half of the patients required shunt revision with the majority of these requiring multiple revisions. We suggest that CSF shunting should be conducted as a last resort in those with otherwise untreatable, rapidly declining vision. Alternative treatments, such as weight reduction, may be more effective with less associated morbidity.

scholarly journals New horizons for idiopathic intracranial hypertension: advances and challenges

2020 ◽  
Vol 136 (1) ◽  
pp. 118-126
Author(s):  
Susan P Mollan ◽  
Olivia Grech ◽  
Zerin Alimajstorovic ◽  
Benjamin R Wakerley ◽  
Alexandra J Sinclair
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Surgical Intervention ◽  
Central Adiposity ◽  
Opening Pressure ◽  
Obesity Epidemic ◽  
New Horizons ◽  
Obesity Stigma ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Abstract Introduction Idiopathic intracranial hypertension (IIH) is becoming a recognized condition due to the increasing incidence linked to a global obesity epidemic. Sources of data All English papers on PubMed, Cochrane and Scholar between inception until 1 March 2020 were considered. Areas of agreement Studies suggest central adiposity has a pathogenic role. Recent weight gain is a risk factor and weight loss has a key role in management. Areas of controversy Interpretation of abnormal lumbar puncture opening pressure is debated. There is an increasing recognition of obesity stigma and how this should be approached. Growing points Further evidence is required for the choice of surgical intervention for fulminant IIH. Education regarding IIH should be evidence based. Areas timely for developing research Novel research of the pathology of IIH is influencing development of therapies such as glucagon-like peptide-1 receptor agonists and targeting unique androgen signatures. The newly discovered cardiovascular risk requires further attention.

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