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J Obes. 2017;2017:5348928. doi: 10.1155/2017/5348928. Epub 2017 Aug 13.

Idiopathic Intracranial Hypertension: Prognostic Factors and Multidisciplinary Management.

Author information

1
Department of Neurology, Stroke Unit, University Hospital of Nancy, 54035 Nancy, France.
2
Centre d'Investigation Clinique Plurithématique (CIC-P 1433), INSERM U1116, University Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France.
3
Department of Neuroradiology, University Hospital of Nancy, 54035 Nancy, France.

Abstract

BACKGROUND:

Idiopathic intracranial hypertension (IIH) mostly affects young obese women and can lead to permanent visual impairment. However, prognostic factors and therapeutic strategy remain unclear.

METHODS:

We retrospectively collected data from all patients diagnosed and managed for IIH in our university center from January 2001 to December 2016.

RESULTS:

Seventy-nine patients were diagnosed with IIH. Bilateral transverse sinus stenosis (TSS) was found in 74% of the population. Visual outcome at 6 months was poor for 46% of patients, including all patients presenting weight gain of at least 5% since diagnosis (p < 0.001), whereas mean body mass index at diagnosis was not different between patients with poor versus good outcome (32.9 ± 7.7 versus 34.6 ± 9.4 kg·m-2). Other significant factors of poor prognosis were bilateral TSS (OR = 5.2; 95 CI: 1.24-24.9; p = 0.024). Thirteen patients with poor outcome after 6-month assessment underwent unilateral TSS stenting leading to visual improvement in 11 cases.

CONCLUSION:

Weight gain, rather than initial weight, emerged as the leading factor of poor visual outcome in patients with IIH, followed by presence of bilateral TSS. Consequently, first-line treatment must include dietary measures to control weight. Unilateral stenting appears to be a safe second-line treatment option for patients with bilateral TSS.

PMID:
28884026
PMCID:
PMC5572623
DOI:
10.1155/2017/5348928
[Indexed for MEDLINE]
Free PMC Article

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