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2017 ; 2017
(ä): 5348928
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Idiopathic Intracranial Hypertension: Prognostic Factors and Multidisciplinary
Management
#MMPMID28884026
Chagot C
; Blonski M
; Machu JL
; Bracard S
; Lacour JC
; Richard S
J Obes
2017[]; 2017
(ä): 5348928
PMID28884026
show ga
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.