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Idiopathic intracranial hypertension from the perspective of headache center

Abstract

Idiopathic intracranial hypertension (IIH) is a pathological state defined as an increase of intracranial pressure in the absence of a causative pathological process. The aim of this study was to evaluate the clinical features of the patients with IIH diagnosed in our Headache Center according to the current knowledge of this disorder. In the retrospective and cross-sectional analysis of 3395 patients we present 12 newly diagnosed IIH patients, ten women and two men, aged from 19 to 51, with obtained values of cerebrospinal fluid pressure between 250 and 680 mm of water. The symptoms of IIH clinical presentation have been headache, reported by 92 % of patients; papilledema, noted in 67 %; and cranial nerve impairment (25 %). The results obtained from presented patients confirmed the presence of headache features that are included in criteria for headache attributed with IIH in majority of them: progressive, daily, diffuse, non-pulsatile headache with aggravation by coughing or straining. Decrease of pain intensity after lumbar puncture was noted in all patients. We notice the relatively small proportion of patients with headache attributed to IIH among the patients treated in our Headache Center. The prevalence of IIH is not low and headache is the most frequent presenting symptom; therefore, we could only conclude that some chronic headache patients refractory for treatment are patients with IIH.

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References

  1. Dhungana S, Sharrack B, Woodroofe N (2010) Idiopathic intracranial hypertension. Acta Neurol Scand 121(2):71–82

    PubMed  Article  CAS  Google Scholar 

  2. Friesner D, Rosenman R, Lobb BM, Tanne E (2011) Idiopathic intracranial hypertension in the USA: the role of obesity in establishing prevalence and healthcare costs. Obes Rev 12(5):e372–e380

    PubMed  Article  CAS  Google Scholar 

  3. Kerty E, Heuser K, Indahl UG, Berg PR, Nakken S, Lien S, Omholt SW, Ottersen OP, Nagelhus EA (2013) Is the brain water channel aquaporin-4 a pathogenetic factor in idiopathic intracranial hypertension? Results from a combined clinical and genetic study in a Norwegian cohort. Acta Ophthalmol 91(1):88–91

    PubMed  Article  CAS  Google Scholar 

  4. Dhungana S, Sharrack B (2009) Cytokines and chemokines in idiopathic intracranial hypertension. Headache J Head Face Pain 49(2):282–285

    Article  Google Scholar 

  5. Bono F, Giliberto C, Mastrandrea C et al (2005) Transverse sinus stenoses persist after normalization of the CSF pressure in IIH. Neurology 65:1090–1093

    PubMed  Article  CAS  Google Scholar 

  6. Wall M (2010) Idiopathic intracranial hypertension. Neurol Clin 28(3):593–617

    PubMed  Article  Google Scholar 

  7. Yri HM, Wegener M, Sander B, Jensen R (2012) Idiopathic intracranial hypertension is not benign: a long-term outcome study. J Neurol 259(5):886–894

    PubMed  Article  Google Scholar 

  8. Raoof N, Sharrack B, Pepper IM, Hickman SJ (2011) The incidence and prevalence of idiopathic intracranial hypertension in Sheffield, UK. Europ J Neurol 18(10):1266–1268

    Article  CAS  Google Scholar 

  9. Skau M, Brennum J, Gjerris F, Jensen R (2005) What is knew about idiopathic intracranial hypertension? An updated review of mechanism and treatment. Cephalalgia 26:384–399

    Article  Google Scholar 

  10. Headache Classification Subcommittee of the International Headache Society (2004) International classification of headache disorders, 2nd edition. Cephalalgia 24:1–160

    Google Scholar 

  11. Friedman DI, Jacobson DM (2002) Diagnostic criteria for idiopathic intracranial hypertension. Neurology 59(10):1492–1495

    PubMed  Article  Google Scholar 

  12. Amico DD, Curone M, Farago G, Mea E, Tullo V, Proietti A, Bianchi Marzoli S, Ciasca P, Bussone G (2012) Headache in patients with idiopathic intracranial hypertension: a pilot study to assess applicability of ICHD-2 diagnostic criteria. Neurol Sci 33(Suppl 1):S189–S191

    PubMed  Google Scholar 

  13. Friedman DI, Rausch EA (2002) Headache diagnoses in patients with treated idiopathic intracranial hypertension. Neurology 58(10):1551–1553

    PubMed  Article  Google Scholar 

  14. Wall M (1990) The headache profile of idiopathic intracranial hypertension. Cephalalgia 10(6):331–335

    PubMed  Article  CAS  Google Scholar 

  15. Thurtell M, Newman N, Biousse V (2010) Visual loss without papilledema in idiopathic intracranial hypertension. J Neuro ophthalmol 30(1):96–98

    Article  Google Scholar 

  16. Digre KE, Nakamoto BK, Warner JEA, Langeberg WJ, Baggaley SK, Katz BJ (2009) A comparison of idiopathic intracranial hypertension with and without papilledema. Headache 49:187

    Article  Google Scholar 

  17. Nedelmann M, Kaps M, Mueller-Forell W (2009) Venous obstruction and jugular valve insufficiency in idiopathic intracranial hypertension. J Neurol 256(6):964–969

    PubMed  Article  Google Scholar 

  18. Farb RI, Vanek I, Scott JN, Mikulis DJ, Willinsky RA, Tomlinson G, ter Brugge KG (2003) Idiopathic intracranial hypertension: the prevalence and morphology of sinovenous stenosis. Neurology 60(9):1418–1424

    PubMed  Article  CAS  Google Scholar 

  19. Silberstein SD, McKinstry RC (2003) The death of idiopathic intracranial hypertension? Neurology 60(9):1406–1407

    PubMed  Article  Google Scholar 

  20. Safavi-Abbasi S, Di Rocco F, Nakaji P et al (2008) Thrombophilia due to factor V and II mutations and formation of a dural arteriovenous fistula: case report and review of a rare entity. Skull Base 18(2):135–142

    PubMed  Article  Google Scholar 

  21. Higgins JNP, Gillard JH, Owler BK, Harkness K, Pickard JD (2004) MR venography in idiopathic intracranial hypertension: unappreciated and misunderstood. J Neurol Neurosurg Psychia 75(4):621–625

    Article  CAS  Google Scholar 

  22. Bicakci K, Bicakci S, Aksungur E (2006) Perfusion and diffusion magnetic resonance imaging in idiopathic intracranial hypertension. Acta Neurol Scand 114:193–197

    PubMed  Article  CAS  Google Scholar 

  23. Albuquerque FC, Dashti SR, Hu YC, Newman CB, Teleb M, McDougall CG, Rekate HL (2011) Intracranial venous sinus stenting for benign intracranial hypertension: clinical indications, technique, and preliminary results. World Neurosurg 75(5–6):648–652

    PubMed  Article  Google Scholar 

  24. Glueck CJ, Aregawi D, Goldenberg N, Golnik KC, Sieve L, Wang P (2005) Idiopathic intracranial hypertension, polycystic-ovary syndrome, and thrombophilia. J Lab Clin Med 145(2):72–82

    PubMed  Article  Google Scholar 

  25. Antonopoulou M, Sharma R, Farag A, Banerji MA, Karam JG (2012) Hypopituitarism in the elderly. Maturitas 72(4):277–285

    PubMed  Article  CAS  Google Scholar 

  26. Batra S, Miller NR, Subramanian PS, Radvany M, Gailloud P, Rigamonti D (2013) Pseudotumor cerebri syndrome: a review. Contemp Neurosurg 35(2):1–8

    Article  Google Scholar 

  27. Anat K, Efrat K, Einor Ben A, Eti Z, Varda D, Uriel M, Aharon L, Shlomo B (2010) Thrombophilic factors in idiopathic intracranial hypertension: a report of 51 patients and a meta-analysis. Blood Coagul Fibrinol 21(4):328–333

    Article  Google Scholar 

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Acknowledgments

This work was started during the study residence of Dr. Srdjan Ljubisavljevic at the Clinic for Neurology, Clinical Center of Serbia. The author is indebted to the Clinic staff and the other resident physicians for their understanding and support during his engagement.

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No conflict of interest exists for any of the authors listed in the article.

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Correspondence to Srdjan Ljubisavljevic.

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Ljubisavljevic, S., Trajkovic, J.Z., Sternic, N.C. et al. Idiopathic intracranial hypertension from the perspective of headache center. Acta Neurol Belg 113, 487–492 (2013). https://doi.org/10.1007/s13760-013-0228-0

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  • DOI: https://doi.org/10.1007/s13760-013-0228-0

Keywords

  • Idiopathic intracranial hypertension
  • Headache