Summary According to the definition, idiopathic intracranial hypertension (IIH) is a pathological state characterized by an increase in intracranial pressure; however, there are no obvious intracranial pathological processes. The pathophysiology of this disorder is not clear, although there are many reports related to it.We present an overview of possible etiopathogenetic mechanisms, clinical presentations and therapeutic interventions from a series of patients hospitalized with the clinical picture and final diagnosis of idiopathic intracranial hypertension (IIH). All data were collected from the moment of IIH diagnosis as well as three months later. The obtained data showed that IIH is a disease that primarily affects obese women in early and midlife. The positive correlation between values of cerebrospinal fluid pressure and body mass index was observed. The disorders of sexual hormones were identified as a possible etiology for IIH female patients. Headache, papilloedema, decreased visual acuity, vertigo and cranial nerve palsy were identified as the most prevalent IIH clinical presentations. The existence of stenosis and hypoplasia of the sigmoid and transverse sinus were confirmed only in one third of IIH patients. Pharmacotherapy combined with weight loss was efficacious in a large number of patients. In this series, there were no short-term consequences of IIH.The results suggest the importance of early and accurate looking for IIH in obese early and midlife women with any hormonal imbalances having a variety of neurological expression, mostly presented as headaches and visual disturbances. Early detection of IIH might influence the timely treatment and prevent far-reaching and severe clinical consequences.
References
1.
Bono F, Giliberto C, Mastrandrea C, Cristiano D, Lavano A, Fera F, et al. Transverse sinus stenoses persist after normalization of the CSF pressure in IIH. Neurology. 2005;65(7):1090–3.
Wall M. Idiopathic Intracranial Hypertension and the Idiopathic Intracranial Hypertension Treatment Trial. Journal of Neuro-Ophthalmology. 2013;33(1):1–3.
4.
Tse C, Klein R. Intracranial hypertension associated with systemic lupus erythematosus in a young male patient. Lupus. 2013;22(2):205–12.
5.
Friesner D, Rosenman R, Lobb BM, Tanne E. Idiopathic intracranial hypertension in the USA: the role of obesity in establishing prevalence and healthcare costs. Obesity Reviews. 2011;12(5).
6.
Peng KP, Fuh JL, Wang SJ. High-pressure headaches: idiopathic intracranial hypertension and its mimics. Nature Reviews Neurology. 2012;8(12):700–10.
7.
Digre KB, Corbett JJ. Pseudotumor Cerebri in Men. Archives of Neurology. 1988;45(8):866–72.
8.
Glueck CJ, Aregawi D, Goldenberg N, Golnik KC, Sieve L, Wang P. Idiopathic intracranial hypertension, polycystic-ovary syndrome, and thrombophilia. Journal of Laboratory and Clinical Medicine. 2005;145(2):72–82.
9.
Nedelmann M, Kaps M, Mueller-Forell W. Venous obstruction and jugular valve insufficiency in idiopathic intracranial hypertension. Journal of Neurology. 2009;256(6):964–9.
10.
Silberstein SD, McKinstry RC. The death of idiopathic intracranial hypertension? Neurology. 2003;60(9):1406–7.
11.
Donaldson JO, Horak E. Cerebrospinal fluid oestrone in pseudotumour cerebri. Journal of Neurology, Neurosurgery & Psychiatry. 1982;45(8):734–6.
12.
Lecube A, Poca MA, Colomé N, Bech‐Serra JJ, Hernández C, García‐Ramírez M, et al. Proteomic Analysis of Cerebrospinal Fluid from Obese Women with Idiopathic Intracranial Hypertension: A New Approach for Identifying New Candidates in the Pathogenesis of Obesity. Journal of Neuroendocrinology. 2012;24(6):944–52.
13.
Bruce BB, Kedar S, Van Stavern GP, Corbett JJ, Newman NJ, Biousse V. Atypical idiopathic intracranial hypertension. Neurology. 2010;74(22):1827–32.
14.
Thurtell MJ, Newman NJ, Biousse V. Visual Loss Without Papilledema in Idiopathic Intracranial Hypertension. Journal of Neuro-Ophthalmology. 2010;30(1):96–8.
15.
Ooi LY, Walker BR, Bodkin PA, Whittle IR. Idiopathic intracranial hypertension: Can studies of obesity provide the key to understanding pathogenesis? British Journal of Neurosurgery. 2008;22(2):187–94.
16.
Wall M. Idiopathic Intracranial Hypertension. Neurologic Clinics. 2010;28(3):593–617.
17.
Yri HM, Wegener M, Sander B, Jensen R. Idiopathic intracranial hypertension is not benign: a long-term outcome study. Journal of Neurology. 2012;259(5):886–94.
18.
Ball AK, Howman A, Wheatley K, Burdon MA, Matthews T, Jacks AS, et al. A randomised controlled trial of treatment for idiopathic intracranial hypertension. Journal of Neurology. 2011;258(5):874–81.
19.
Skau M, Brennum J, Gjerris F, Jensen R. What is New About Idiopathic Intracranial Hypertension? An Updated Review of Mechanism and Treatment. Cephalalgia. 2006;26(4):384–99.
20.
Shah VA, Kardon RH, Lee AG, Corbett JJ, Wall M. Long-term follow-up of idiopathic intracranial hypertension. Neurology. 2008;70(8):634–40.
21.
Dhungana S, Sharrack B, Woodroofe N. Cytokines and Chemokines in Idiopathic Intracranial Hypertension. Headache: The Journal of Head and Face Pain. 2009;49(2):282–5.
22.
Antonopoulou M, Sharma R, Farag A, Banerji MA, Karam JG. Hypopituitarism in the elderly. Maturitas. 2012;72(4):277–85.
23.
Safavi-Abbasi S, Di Rocco F, Nakaji P, Feigl G, Gharabaghi A, Samii M, et al. Thrombophilia Due to Factor V and Factor II Mutations and Formation of a Dural Arteriovenous Fistula: Case Report and Review of a Rare Entity. Skull Base. 2008;18(2):135–43.
24.
Thomas S, Baheti N, Nair M. Long-term visual outcome in idiopathic intracranial hypertension. Annals of Indian Academy of Neurology. 2011;14(1):19.
25.
Mensah A, Milea D, Jensen R, Fledelius H. Persistent visual loss in malignant idiopathic intracranial hypertension. Acta Ophthalmologica. 2009;87(8):934–6.
26.
Friedman DI. Medication-Induced Intracranial Hypertension in Dermatology. American Journal of Clinical Dermatology. 2005;6(1):29–37.
27.
Ljubisavljevic S, Trajkovic JZ, Sternic NC, Spasic M, Kostic V. Idiopathic intracranial hypertension from the perspective of headache center. Acta Neurologica Belgica. 2013;113(4):487–92.
28.
Friedman DI. Idiopathic intracranial hypertension. Current Pain and Headache Reports. 2007;11(1):62–8.
Farb RI, Vanek I, Scott JN, Mikulis DJ, Willinsky RA, Tomlinson G, et al. Idiopathic intracranial hypertension. Neurology. 2003;60(9):1418–24.
31.
Purvin VA. Papilledema and Obstructive Sleep Apnea Syndrome. Archives of Ophthalmology. 2000;118(12):1626.
32.
Biousse V, Bruce BB, Newman NJ. Update on the pathophysiology and management of idiopathic intracranial hypertension. Journal of Neurology, Neurosurgery & Psychiatry. 2012;83(5):488–94.
33.
Kerty E, Heuser K, Indahl UG, Berg PR, Nakken S, Lien S, et al. Is the brain water channel aquaporin‐4 a pathogenetic factor in idiopathic intracranial hypertension? Results from a combined clinical and genetic study in a Norwegian cohort. Acta Ophthalmologica. 2013;91(1):88–91.
34.
Kapoor KG. Etiology of dizziness, tinnitus, and nausea in idiopathic intracranial hypertension. Medical Hypotheses. 2008;71(2):310–1.
35.
Higgins JNP. MR venography in idiopathic intracranial hypertension: unappreciated and misunderstood. Journal of Neurology, Neurosurgery & Psychiatry. 2004;75(4):621–5.
36.
Raoof N, Sharrack B, Pepper IM, Hickman SJ. The incidence and prevalence of idiopathic intracranial hypertension in Sheffield, UK. European Journal of Neurology. 2011;18(10):1266–8.
37.
Digre KB, Nakamoto BK, Warner JEA, Langeberg WJ, Baggaley SK, Katz BJ. A Comparison of Idiopathic Intracranial Hypertension With and Without Papilledema. Headache: The Journal of Head and Face Pain. 2009;49(2):185–93.
38.
Bruce BB, Kedar S, Van Stavern GP, Monaghan D, Acierno MD, Braswell RA, et al. Idiopathic intracranial hypertension in men. Neurology. 2009;72(4):304–9.
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