Abstract Details

Title Immediate Resolution of Idiopathic Intracranial Hypertension with Drainage of CSF at Low Pressure

Topic Neuro-ophthalmology/Neuro-otology

Presentation(s) P02 - (-)

Poster/Presentation
Number 246

Objective

Background BACKGROUND: IIH is a condition of unknown aetiology where elevated intracranial pressure results in intractable headache and may cause nausea, vomiting and visual obscurations. The most significant sequel of IIH is severe visual field loss or blindness. When refractory to medical treatment, the condition requires surgical intervention.

Design/Methods DESIGN/METHODS: From the outpatient clinic we identified thirteen patients who fulfilled the Dandy Criteria for IIH (headache, papilloedema, a CSF opening pressure of > 25 cm H2O, normal CSF and exclusion of cerebral vein thrombosis by venography). Seven were followed prospectively 6 were reviewed retrospectively. Resolution of IIH was defined as headache free, off treatment with resolution of papilloedema confirmed by an ophthalmologist.

Results RESULTS: All 13 patients experienced immediate resolution of IIH symptoms (headache and subsequently papilloedema) after experiencing low pressure headache indicating a period of CSF drainage at a very low pressure. The low pressure was confirmed by LP in 2 patients at 5 and 7 cm H2O. The minimum period of low pressure headache was 2 days. Of the 13 patients, 11 remain symptom free for up to 10 years (mean 3.5 years). In two retrospective cases symptoms recurred at 3 months and 2 years after initial resolution.

Conclusions CONCLUSIONS: The development of low pressure headache in our series of patients with IIH was associated with a favorable prognosis. The results if confirmed suggest that early induction of a critically low CSF pressure combined with a period of CSF drainage in patients with IIH may alter the clinical course of this disorder and the associated risks of severe visual field loss or blindness.

Authors/Disclosures
Peter C. Gates, MD, MBBS, FR, FAAN PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file

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