KesKın Ahmet Onur, İdıman Fethi, Kaya Derya, Bırcan Behice
Neurology Department, Eskişehir Yunus Emre State Hospital Neurology Clinic, Eskişehir, Turkey.
Neurology Department, Dokuz Eylül University School of Medicine, İzmir, Turkey.
Noro Psikiyatr Ars. 2018 Jul 5;57(1):23-26. doi: 10.5152/npa.2017.12558. eCollection 2020 Mar.
Idiopathic intracranial hypertension (IIH) occurs due to increased intracranial pressure (ICP), is most commonly encountered in obese women, and may lead to loss of vision. This study aimed to determine the demographic features, clinical signs and symptoms, and radiological findings of patients with IIH, and to investigate the factors associated with the prognosis.
Patients with IIH who were examined and followed-up between January 1992-January 2012 in the Neuro-ophthalmology Unit were retrospectively evaluated. Patients were diagnosed based on the modified Dandy criteria.
The mean age of 59 patients included in the study (female, 88.1%) was 30.25±13.12 years. Reported complaints were headache (78.0%), transient visual obscuration (45.8%), nausea (32.2%), dizziness (16.9%), and diplopia (13.6%). Of the patients 69.4% had visual field deficits, and 71% had papilledema (66.1% were bilateral). The rate of obesity was 20.3%. The prognosis was good in 64.7% of the patients, and 35.3% of the patients clinically worsened. Recurrence of symptoms was observed in 33% of the patients and 4 patients had severe permanent vision loss. Demographic features, initial complaints, mean ICP, and pathological magnetic resonance imaging findings were not associated with the prognosis. Delay in treatment and generalized constriction in the visual field were associated with the poor prognosis.
Compared to patients with IIH in the western population, obesity was less frequent in the present study. Initial visual field defects, especially the generalized constriction and delay to treatment were related to poor prognosis. Cessation of medical treatment was a factor for recurrence. Early diagnosis and appropriate treatment may subside the severity of permanent vision loss in fulminant IIH.
特发性颅内高压（IIH）是由于颅内压（ICP）升高引起的，最常见于肥胖女性，可能导致视力丧失。本研究旨在确定IIH患者的人口统计学特征、临床体征和症状以及影像学表现，并探讨与预后相关的因素。
对1992年1月至2012年1月在神经眼科病房接受检查和随访的IIH患者进行回顾性评估。患者根据改良的丹迪标准进行诊断。
纳入研究的59例患者（女性，88.1%）的平均年龄为30.25±13.12岁。报告的症状有头痛（78.0%）、短暂性视力模糊（45.8%）、恶心（32.2%）、头晕（16.9%）和复视（13.6%）。69.4%的患者有视野缺损，71%的患者有视乳头水肿（66.1%为双侧）。肥胖率为20.3%。64.7%的患者预后良好，35.3%的患者临床症状恶化。33%的患者出现症状复发，4例患者有严重的永久性视力丧失。人口统计学特征、初始症状、平均ICP和病理磁共振成像表现与预后无关。治疗延迟和视野普遍收缩与预后不良有关。
与西方人群的IIH患者相比，本研究中肥胖的发生率较低。初始视野缺损，尤其是普遍收缩和治疗延迟与预后不良有关。停药是复发的一个因素。早期诊断和适当治疗可能减轻暴发性IIH中永久性视力丧失的严重程度。
