European Headache Federation guideline on idiopathic intracranial hypertension

Abstract

BackgroundIdiopathic Intracranial Hypertension (IIH) is characterized by an elevation of intracranial pressure (ICP no identifiable cause. The aetiology remains largely unknown, however observations made in a number of recent clinical studies are increasing the understanding of the disease and now provide the basis for evidence-based treatment strategies.MethodsThe Embase, CDSR, CENTRAL, DARE and MEDLINE databases were searched up to 1st June 2018. We analyzed randomized controlled trials and systematic reviews that investigate IIH.ResultsDiagnostic uncertainty, headache morbidity and visual loss are among the highest concerns of clinicians and patients in this disease area. Research in this field is infrequent due to the rarity of the disease and the lack of understanding of the underlying pathology.ConclusionsThis European Headache Federation consensus paper provides evidence-based recommendations and practical advice on the investigation and management of IIH.Electronic supplementary materialThe online version of this article (10.1186/s10194-018-0919-2) contains supplementary material, which is available to authorized users.

Neuro-ophthalmological biomarkers of visual outcome in newly diagnosed idiopathic intracranial hypertension

“…This finding direct us to re-consider the ideal timing of LPS and avoid postponing which may results in irreversible visual affection. This observation is in accordance with the work of Hoffmann and colleagues 2018 [12] and Wall and colleagues 2017 [6] who stated that delayed affection of the central vision in IIH may result in initial misdiagnosis which may result in irreversible visual affection.…”

“…Patients needed neurosurgical intervention experienced rapid disease progression with short HPT (fulminant IIH). This finding is passing with that of Hoffmann and colleagues 2018 [12] and Mulroy and colleagues 2018 [13] who stated that most IIH patients have a relatively benign, self-limiting course except in those with rapid progressive course and fast diminution of vision who carry worse visual outcomes and necessitate rapid CSF shunting.…”

<p>Exploring The Current Management Idiopathic Intracranial Hypertension, And Understanding The Role Of Dural Venous Sinus Stenting</p>

“…In less than 10% of IIH 4 present with rapidly progressive loss of visual function (termed fulminant IIH) and in whom an acute reduction in ICP is required to preserve vision, surgical interventions are necessary. 16,26 Such options include CSF diversion with the commonest surgeries being a ventriculoperitoneal shunt or lumboperitoneal shunt, or optic nerve sheath fenestration (ONSF).…”

Stauungspapille, Pseudotumor cerebri und idiopathische intrakranielle Hypertension – Was gibt es Neues?

“…Die 3. Version der International Classification of Headache Disorders (ICHD-3) beinhaltet gar keine Beschreibung des IIH-bedingten Kopfschmerzes mehr, sondern definiert lediglich, dass das Auftreten des Kopfschmerzes in zeitlichem Zusammenhang zur Diagnose der IIH stehen muss und/oder mit einem pulsierenden Tinnitus oder Stauungspapillen zeitgleich auftreten muss [23]. Die Ursachen für den IIH-assoziierten Kopfschmerz sind weiter ungeklärt und stehen in keinem direkten Zusammenhang zum erhöhten Hirndruck: Bei ca.…”