The role of opening CSF pressure in response to treatment for idiopathic intracranial hypertension (IIH). (June 2020)

• Record Type: Journal Article
• Authors: Togha, Mansoureh; Martami, Fahimeh; Rahmanzadeh, Reza; Ghorbani, Zeinab; Refaeian, Farshid; Behbahani, Shirin; Panahi, Parsa; Moghadam, Nahid Beladi; Nafissi, Shahriar; Shahbazi, Mojtaba
• Is Part Of: Journal of clinical neuroscience. Volume 76(2020)
• Page Start: 171
• Page End: 176
• Publication Date: 2020-06
• Subjects: Idiopathic intracranial hypertension -- CSF pressure -- Risk factors -- Headache; IIH idiopathic intracranial hypertension -- CSF Cerebrospinal fluid -- IICP increased intracranial pressure -- IIHTT Idiopathic Intracranial Hypertension Treatment Trial -- LP lumbar puncture -- MRI Magnetic resonance imaging -- VA visual acuity -- OCT optic coherence tomography -- BMI Body mass index -- TP Theco-peritoneal -- VP ventriculo-peritoneal -- ONF Optic nerve fenestration -- SD standard deviation -- ANOVA one-way analysis of variance; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2020.04.066
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: IIH severity could be classified according to therapeutic strategies. There is a strong association between the opening CSF pressure and IIH severity. Higher CSF pressure could be the risk factors of poor response to therapy. Headache without blurred vision could be a prognostic factor for good response to treatment. Abstract: The aim of the current study was to assess the risk factors, clinical symptoms and Cerebrospinal fluid (CSF) pressure of idiopathic intracranial hypertension (IIH) with emphasis on determining the risk factors which involved in poor response to treatment. We retrospectively included 202 patients who were diagnosed with IIH. Disease severity was classified according to prescribed therapeutic option into 4 groups: acetazolamide (group 1), Acetazolamide plus topiramate or Lasix (group 2), repeated LP (group 3) and surgical intervention (group 4). Being in the higher group was considered as a higher severity of disease and poor response to treatment. Among the evaluated features of IIH, the strongest association were observed between opening CSF pressure and disease severity. So that, the highest CSF pressure was observed in patients who underwent surgery, which represent the highest severity of disease (group 4) and poor response to therapy (mean ± SD: 43.9 ± 21.1 cm H2 O). Headache was the most prevalent symptom of IIH in our series which was significantly higher among acetazolamide group. Blurred vision was the second most common symptoms which, unlike the headache was more reported in surgery group. Our results suggested that higher CSF pressure could be the risk factors of poor response to therapy, which may raise need for more intensive treatment. Furthermore, suffering of headache without blurred vision can consider as a prognostic factor for mild severity and good response to treatment.