MRI features of idiopathic intracranial hypertension are not prognostic of visual and headache outcome

Bsteh, Gabriel; Marik, Wolfgang; Krajnc, Nik; Macher, Stefan; Mitsch, Christoph; Pruckner, Philip; Novak, Klaus; Wöber, Christian; Pemp, Berthold

doi:10.1186/s10194-023-01641-x

Cited by 6 publications

(2 citation statements)

References 37 publications

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“…While these findings increase the likelihood of IIH diagnosis, they do not predict visual involvement. In addition, the absence of positive findings does not rule out the diagnosis of IIH 19 20…”

Section: Discussionmentioning

confidence: 99%

Idiopathic intracranial hypertension in two twin sisters

Jirapanyayut,

March de Ribot,

March de Ribot

2024

BMJ Case Rep

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Idiopathic intracranial hypertension (IIH) is a condition of unknown aetiology characterised by an increase in the intracranial pressure. Familial cases of IIH are rare and not well-understood. We present two monozygotic twins who developed IIH two years apart. The case involves two monozygotic female twins developing IIH in their 50s. They presented with a history of blurry vision and headaches. The diagnosis included the neurological, radiological and ophthalmological examination, excluding other causes. Both patients received treatment with acetazolamide, successfully resolving the papilloedema and restoring a normal visual field. This case highlights the occurrence of IIH among twins presenting at similar periods, emphasising the potential genetic influence. Clinicians should alert and educate the family regarding the risk factors and potential symptoms of this condition in the unlikely occurrence that other family members are affected.

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Section: Discussionmentioning

confidence: 99%

Idiopathic intracranial hypertension in two twin sisters

Jirapanyayut,

March de Ribot,

March de Ribot

2024

BMJ Case Rep

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“…Friedman et al proposed novel diagnostic criteria for IIH in 2002, which were revised in 2013 [18,19]. These criteria have been accepted in current guidelines [20] and confirmed in clinical trials [21]. The defining features are a CSF opening pressure ≥25 cmH 2 O and the presence of papilledema next to a more rigorous exclusion of secondary causes to secure a definite diagnosis of IIH.…”

Section: Introductionmentioning

confidence: 99%

Clinical Course and Ophthalmologic Findings in Idiopathic Intracranial Hypertension and Pregnancy

Knoche,

Danyel,

Varlet

et al. 2023

Brain Sciences

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Idiopathic intracranial hypertension (IIH) has its highest prevalence among women of childbearing age and therefore frequently coincides with pregnancy. This retrospective cohort study aimed to explore the impact of pregnancy on the clinical course, ophthalmologic findings and on the therapeutic management of IIH patients. Individual patient records were reviewed for neuro-ophthalmologic findings, treatment strategy, adherence to therapy and pregnancy complications. Sixteen patients with 19 documented pregnancies were identified. The visual acuity, visual field defects and the grade of papilledema at baseline and after pregnancy were compared. The visual acuity and visual field mean deviation at baseline and at follow-up after pregnancy did not significantly differ. Papilledema at baseline was more pronounced in patients who had been diagnosed with IIH during pregnancy than in patients with established IIH. In this cohort, the visual acuity and the visual field were not lastingly impacted by pregnancy. The adherence to therapy was low, with 69% discontinuing treatment or medication.

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Transorbital B-mode ultrasound for the assessment of posterior globe flattening in idiopathic intracranial hypertension: a pilot study

Knoche,

Pietrock,

Neumann

et al. 2024

Ultrasound J

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Background Posterior globe flattening (PGF) is a specific neuroimaging sign in patients with idiopathic intracranial hypertension (IIH), but its detection is based on subjective qualitative neuroradiological assessment. This study sought to evaluate the utility of transorbital ultrasound to detect and quantify PGF in IIH patients using the Posterior Globe Angle (PGA). Methods Consecutive IIH patients and healthy controls were enrolled in a prospective case-control study. Transorbital ultrasound was performed to assess the presence of PGF. For quantification of PGF, an angular measurement (PGA) was performed with the vertex centering the optic nerve at a predefined distance from the lamina cribrosa and angle legs tangentially aligned to the borders of the vitreous body. PGA measurements were compared between IIH patients and healthy controls. Additionally, the diagnostic accuracy of PGA measurements in detecting PGF was evaluated using ROC analysis. Results Thirty-one IIH patients (37.3 ± 12.3 years, 29 female) and 28 controls (33.3 ± 11.8 years, 21 female) were compared. PGF was present in 39% of IIH patients and absent in the control group. PGA3mm measurements significantly differed between IIH and controls (116.5° ± 5.5 vs. 111.7° ± 2.9; p < 0.001). A PGA3mm cutoff of ≥ 118.5° distinguished IIH patients from controls with 100% specificity, while retaining a sensitivity of 37.5%. Conclusions Transorbital ultrasound may be applied to detect and quantify PGF in IIH patients. Prospective, multicenter studies with extended cohorts and blinded design are needed to validate these preliminary findings and confirm the diagnostic utility of transorbital ultrasound for the assessment of PGF in IIH.

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MRI features of idiopathic intracranial hypertension are not prognostic of visual and headache outcome

Cited by 6 publications

References 37 publications

Idiopathic intracranial hypertension in two twin sisters

Idiopathic intracranial hypertension in two twin sisters

Clinical Course and Ophthalmologic Findings in Idiopathic Intracranial Hypertension and Pregnancy

Transorbital B-mode ultrasound for the assessment of posterior globe flattening in idiopathic intracranial hypertension: a pilot study

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