The Vienna idiopathic intracranial hypertension database—An Austrian registry

• DOI: 10.1007/s00508-023-02252-x
• Publication Date: 2023-08-31T02:01:57Z
• Authors: Philip Pruckner; Christoph Mitsch; Stefan Macher; Nik Krajnc; Wolfgang Marik; Klaus Novak; Christian Wöber; Berthold Pemp; Gabriel Bsteh
• Keywords: Papilledema; Acetazolamide; Pseudotumor cerebri

Summary Background Idiopathic intracranial hypertension (IIH) is becoming increasingly more prevalent bearing the risk of visual impairment and affecting quality life. Clinical presentation outcome are heterogeneous. Large, well-characterized cohorts scarce. Objective To characterize clinical spectrum, diagnostic findings, therapeutic management, IIH. Methods We identified patients with IIH according to modified Friedman criteria treated at our center between 2014 2021. The Vienna database described in detail. Results Of 113 89% were female (mean age 32.3 years). Median body mass index (BMI) was 31.8, 85% overweight (BMI > 25) 5% classified as without papilledema. Headache present 84% showed migraine features 43%. opening pressure lumbar puncture 31 cmH 2 O. Pharmacotherapy (predominantly acetazolamide) established 99%, 56% required least 1 13% a surgical intervention. After median 3.7 years follow-up, 57% had achieved significant weight loss, papilledema 59% headache 76% (58% improved). Comparing initial perimetry abnormal 67% vs. 50% (8% worsened, 24% improved) transorbital sonography 87% 65% optic nerve sheath diameter 5.4 mm 4.9 mm. peripapillary retinal fiber layer thickness decreased from 199 µm 99 ganglion cell volume 1.13 3 1.05 . Conclusion large representative cohort characterizes IIH-related symptoms, treatment, emphasizing substantial long-term sequelae Future analyses will aim refine phenotyping identify factors predicting outcome.