Idiopathic intracranial hypertension in class III obese patients

Published Date: 24th September 2018

Publication Authors: Muttoni E

​

Objectives

Idiopathic intracranial hypertension (IIH) is a syndrome characterised by persistently high intracranial pressure (ICP) in the absence of identifiable ventricular or parenchymal disease. It mainly affects obese patients, with symptoms ranging from persistent headache to complete visual loss. IIH often requires lifelong medical treatment or neurosurgical intervention. Despite its morbidity, the aetiology of IIH is poorly understood, and most current knowledge is based on sporadic case reports and small case series. 

Design

The aim of this retrospective cohort study was to investigate the aetiology of IIH in the obese population using a large, nationwide database. 

Subjects

Patients on the CPRD with a coded clinical diagnosis of obesity were screened for recorded diagnoses of IIH. 608 patients were found. 

Methods

Univariate and multivariate analysis were used to investigate the associations between IIH and age, BMI, lifestyle factors and comorbidities. 

Results

Dyslipidaemia, hypertension, type 2 diabetes, previous cardiovascular disease, chronic renal disease, and anaemia were independent predictors for IIH. On multivariate analysis, a history of cardiovascular disease (OR= 1.681, p =.004) and anaemia (OR= 1.311, p =.033) were the most significant factors. A low BMI was protective (OR= 0.644, p =.001). 

Conclusions

IIH is a multifactorial disease affecting patients with complex backgrounds of metabolic comorbidity. The pathophysiological link between the two may stem from chronic changes in venous pressure affecting CSF resorption.

 

Ardissino, A; Muttoni, E et al. (2018). Idiopathic intracranial hypertension in class III obese patients: an aetiological characterisation based on a nationwide database . British Journal of Neurosurgery. 32 (3), 336

« Back