Clinical analysis of idiopathic intracranial hypertension

Abstract

Objective To analyze the clinical characteristics of idiopathic intracranial hypertension （IIH）to improve the diagnosis rate. Methods Epidemiological characteristics, clinical manifestations, imaging examination results and treatment outcomes of 153 patients with IIH hospitalized in Beijing Tongren Hospital from January 2014 to May 2018 were analyzed retrospectively. The clinical differences between subacute group (14 d to 3 months) and chronic group (> 3 months) were compared. Results One hundred and fifty⁃three cases (subacute group 94 cases and chronic group 59 cases) were observed. There were 37 males and 116 females (1 ∶3.14), 53 obses cases (34.64%), 67 overweight case(43.80%). The main clinical symptoms were visiual loss (77.78%, 119/153), transient visual obscuration (50.33%, 77/153), headache (45.10%, 69/153). Abnormal radiologic signs, including empty sella, distension of the perioptic subarachnoid space (DPSS) and transverse venous sinus stenosis(TVSS) were found in 98 cases(64.05%). Intracranial pressures (ICP) of 112 cases (73.20%) were above 30cmH2O. After treatments (138 cases underwent routine treatments and 15 cases underwent surgery treatments), 86.93% (133/153) patients achieved clinical improvement. The improvement rate of subacute group was significantly higher than that of chronic group [91.49% (86/94) vs. 79.66% (47/59); χ2=4.463, P=0.035]. The incidence of transient visual obscuration in subactue group was significantly lower than that in chronic group [42.55% (40/94) vs. 62.71% (37/59); χ2 =5.892, P =0.015]. No significant differtences of vision loss, headache, tinnitus, diplopia, abnormal image signs or ICP were deteced in patients between subacute group and chronic group. Conclusions IIH is one of the most important causes of vision loss and headache. Women in childbearing period and obese people are susceptible to IIH. Clinicians need to raise the awareness of IIH and give timely treatments.

DOI：10.3969/j.issn.1672⁃6731.2020.07.013