Tian Tian
Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, CHN.
Cureus. 2024 Jul 20;16(7):e64990. doi: 10.7759/cureus.64990. eCollection 2024 Jul.
Introduction Idiopathic intracranial hypertension (IIH) was previously assumed to be rare in Asia. However, it has been increasingly recognized in China in recent years, likely due to pandemic obesity and greater awareness of the condition. The clinical characteristics of IIH in Chinese patients remain unexplored. This study aims to investigate the clinical characteristics of patients with IIH in China. Methods A retrospective chart review of patients diagnosed with IIH at the First Affiliated Hospital of Zhengzhou University was conducted from January 2013 to July 2021. The analysis included demographic data, presenting symptoms, comorbidities, imaging features, laboratory data, intracranial pressure (ICP), treatment modalities, and outcomes. Results The study recruited 199 participants, including 145 females and 54 males, with a mean age at onset of 36 years (range: 27 to 45 years). The participants had a mean body mass index (BMI) of 26 kg/m2 (range: 23.4 to 29.4 kg/m2). Obesity was found in 67 participants (33.7%). The most common clinical symptom reported was headache, which was experienced by 118 (59.3%) participants, followed by decreased vision, which was reported by 115 (57.8%) participants. The main comorbidity among women was anemia (54, 37.2%), while men were more likely to have severe sleep apnea (7, 13%). The most common imaging features were perioptic nerve sheath distension (159, 79.9%) and transverse sinus stenosis (147, 73.9%). Symptoms were relieved with medication in 117 (58.8%) participants, while 72 (36.2%) underwent surgeries such as venous sinus stenting and ventriculoperitoneal shunt. During follow-up, symptoms resolved in 84 (42.2%) participants, while 115 (57.8%) participants experienced symptom improvement. The ratio of decreased vision was higher in females than in males. Conclusion The results provide valuable insights into the clinical features of IIH in this region. China appears to have a lower incidence of obesity compared to Western countries. Among comorbidities related to IIH, anemia and severe sleep apnea were the most common. A significant number of IIH patients underwent surgery. It was found that women had worse visual outcomes compared to men. Further investigation is needed to determine the most effective treatment for IIH in a larger cohort of Chinese patients.
引言
特发性颅内高压(IIH)以往被认为在亚洲较为罕见。然而,近年来在中国其被越来越多地认识到,这可能归因于肥胖流行以及对该病症的认识提高。中国患者中IIH的临床特征仍未得到充分研究。本研究旨在调查中国IIH患者的临床特征。
方法
对2013年1月至2021年7月在郑州大学第一附属医院被诊断为IIH的患者进行回顾性病历审查。分析内容包括人口统计学数据、临床表现、合并症、影像学特征、实验室数据、颅内压(ICP)、治疗方式及治疗结果。
结果
该研究纳入了199名参与者,其中女性145名,男性54名,发病时的平均年龄为36岁(范围:27至45岁)。参与者的平均体重指数(BMI)为26kg/m²(范围:23.4至29.4kg/m²)。67名(33.7%)参与者存在肥胖。报告的最常见临床症状是头痛,118名(59.3%)参与者有此症状,其次是视力下降,115名(57.8%)参与者报告有此症状。女性的主要合并症是贫血(54例,37.2%),而男性更易出现严重睡眠呼吸暂停(7例,13%)。最常见的影像学特征是视神经鞘膜扩张(159例,79.9%)和横窦狭窄(147例,73.9%)。117名(58.8%)参与者通过药物治疗症状得到缓解,72名(36.2%)接受了静脉窦支架置入和脑室腹腔分流等手术。在随访期间,84名(42.2%)参与者症状消失,115名(57.8%)参与者症状改善。女性视力下降的比例高于男性。
结论
研究结果为该地区IIH的临床特征提供了有价值的见解。与西方国家相比,中国的肥胖发病率似乎较低。在与IIH相关的合并症中,贫血和严重睡眠呼吸暂停最为常见。大量IIH患者接受了手术。发现女性的视力预后比男性更差。需要进一步研究以确定针对更大规模中国患者群体的IIH最有效治疗方法。