The incidence and prevalence of idiopathic intracranial hypertension in Sheffield, UK

Raoof, Naz; Sharrack, Basil; Pepper, Irene M; Hickman, Simon J.

doi:10.1111/j.1468-1331.2011.03372.x

Cited by 135 publications

(105 citation statements)

References 18 publications

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“…1 It is a disease linked with obesity, and, in line with increasing levels of obesity in the population, its incidence is increasing. 2 Its importance lies in the fact that it can lead to irreversible vision loss. 3 To date, there are key unanswered questions in the management of IIH in terms of both the aetiology and its treatment.…”

Section: Introductionmentioning

confidence: 99%

Visual Outcomes from Shunting for Idiopathic Intracranial Hypertension

Hickman

Raoof

Panesar

et al. 2014

Neuro-Ophthalmology

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A retrospective notes review was conducted for 50 consecutive patients who underwent shunt surgery for idiopathic intracranial hypertension (IIH). The decimal visual acuity and the mean radial degrees (MRD) of the I4e isopter of the Goldmann visual field were measured pre-operatively and after a mean follow-up period of 1123 days (range: 13-3551 days). A ventriculo-peritoneal shunt was the first procedure in 38 patients and a lumbo-peritoneal shunt in 12. The mean decimal visual acuity of the worse affected eye improved from 0.75 to 0.84, p = 0.011. The MRD score of the worse affected eye improved on average from 25.6 to 35.5 , p50.0001. In those with significant pre-operative visual impairment in their worse affected eye (defined as an MRD score 30 ), the MRD score improved on average from 10.3 to 26.5 , p = 0.0008. The mean number of surgical procedures for each patient was 2.8 (range: 1-15). Taking all surgical procedures into account, post-operative complications were experienced by 30 patients. At last follow-up, 28 patients still complained of headache, 8 of whom had the intervention performed primarily for headache. Shunting can improve visual function in patients with IIH. There is significant post-operative morbidity and often the need for repeated procedures. Headache also commonly remains in these patients. There is a need for a randomised controlled trial of operative interventions in IIH. Sample size calculations for such a trial to treat significant vision loss are presented.

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Section: Introductionmentioning

confidence: 99%

Visual Outcomes from Shunting for Idiopathic Intracranial Hypertension

Hickman

Raoof

Panesar

et al. 2014

Neuro-Ophthalmology

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“…Women are more affected than men, 4 to even 15 times, as has been estimated (4). The frequency of IIH occurrence is 1-2 per 100.000 of the general population, and it is highest in the population of obese women (5). The estimations show that the total IIH widespread presence corresponds to the rate of obesity in an area (1).…”

Section: Introductionmentioning

confidence: 80%

“…The visual impairment due to IIH is the most serious complication (1,5). Considering that the time for these complications can be relatively long, even longer than five years, a long-term follow-up of patients is necessary, even in the cases of good primary response to therapy and the absence of other clinical manifestations of IIH (41,45).…”

Section: Scientificmentioning

confidence: 99%

Idiopathic Intracranial Hypertension – Pathophysiology Based on Case Series

Ljubisavljević¹,

Trajković²

2016

Acta Facultatis Medicae Naissensis

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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. Key words: idiopathic intracranial hypertension, headache, pathophysiology O r i g i n a l a r t i c l e I NT ROD U CT I ONAccording 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 (1, 2).It is widely accepted that IIH usually affects patients who are between 20 and 40 years of age and is combined with obesity. Nevertheless, there are cases when IIH occurs even earlier, although it is not then generally accompanied by obesity (3). Women are more affected than men, 4 to even 15 times, as has been estimated (4). The frequency of IIH occurrence is 1-2 per 100.000 of the general population, and it is highest in the population of obese women (5). The estimations show that the total IIH widespread presence corresponds to the rate of obesity in an area (1). Regarding the existence of IIH, clinical phenotypes with poor clinical presentation, when there are no diagnostic considerations of the disorder, the real incidence and prevalence rates are estimated to be higher than mentioned (6).The possible etiological parameters of this disorder suggest that the basis for ...

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“…It is increasing in incidence in parellel with the current epidemic of obesity 4,5 . Generally causes of IIH are endocrine 6 like adrenal insuffiency, cushings syndrome, hypoparathyroidism, hypothyroidism and hyperthyroidism, drugs like doxycycline,levothyroxine,lithium,nitrofurantoin,tamoxifen,tetracycline,pancreatin and chronic renal failure and SLE 7 . A case control study has found a strong association between IIH and obesity and with weight gain during the 12 months before the IIH diagnosis.…”

Section: Discussionmentioning

confidence: 99%