Clinical and Radiological Characteristics of Non-Obese Female Patients with Idiopathic Intracranial Hypertension.
Anat HorevGal Ben-ArieYair ZlotnikMaor KoltochnikOr Ben ChaimRon BiederkoTamir RegevErez TsumiIlan ShelefYana Mechnik SteenTal EliavMark KatsonErel DomanyAsaf HonigPublished in: Journal of clinical medicine (2024)
While the typical patient with idiopathic intracranial hypertension (IIH) is an obese female of childbearing age, there are unique patient populations, such as non-obese females, that have not been well studied. Characterizing this subpopulation may increase awareness our of it, which may prevent underdiagnosis and improve our understanding of IIH's underlying pathophysiology. We retrospectively reviewed electronic medical records and compared the clinical and radiological characteristics of non-obese (BMI < 30) and obese (BMI > 30) female patients with IIH. Two hundred and forty-six patients (age 32.3 ± 10) met our inclusion criteria. The non-obese patients ( n = 59, 24%) were significantly younger than the obese patients (29.4 ± 9.9 vs. 33.2 ± 10.2, p = 0.004) and had higher rates of severe papilledema (Friesen 4-5; 25.4% vs. 11.8%, p = 0.019), scleral flattening (62.7% vs. 36.9%, p = 0.008), and optic nerve dural ectasia (78.0% vs. 55.6%, p = 0.044). Non-obese patients also had a tendency to have a higher lumbar puncture opening pressure (368 ± 92.7 vs. 344 ± 76.4, p = 0.062). Non-obese patients were three times more likely to present with a combination of scleral flattening and optic nerve dural ectasia (OR = 3.00, CI: 1.57-5.72, χ 2 = 11.63, α < 0.001). Overall, non-obese females with IIH were found to have a more fulminant presentation, typified by higher rates of severe papilledema and radiological findings typical for IIH.
Keyphrases
- obese patients
- optic nerve
- bariatric surgery
- gastric bypass
- roux en y gastric bypass
- weight loss
- optical coherence tomography
- blood pressure
- case report
- body mass index
- end stage renal disease
- type diabetes
- ejection fraction
- chronic kidney disease
- physical activity
- metabolic syndrome
- minimally invasive
- prognostic factors
- patient reported outcomes
- patient reported