Idiopathic Intracranial Hypertension
Conditions
Keywords
Idiopathic intracranial hypertension
Brief summary
Several studies have investigated factors associated with visual deterioration in BIIP patients. Severe papilledema, delayed diagnosis, high CSF opening pressure, obesity, and visual field defects have been associated with poor prognosis. Optical Coherence Tomography has emerged as a valuable tool for monitoring retinal nerve fiber layer changes and detecting optic nerve damage. MRV abnormalities, particularly transverse sinus stenosis, have also gained increasing attention. Recent literature emphasizes the importance of multidisciplinary management involving neurosurgeons, neurologists, ophthalmologists, and radiologists.
Interventions
PROCEDURElumbo-peritoneal shunt
lumbo-peritoneal shunt to decrease the tension the patients those do not treated on medical treatment
DRUGConservative Management: Centered on lifestyle modifications for weight reduction, alongside targeted medical therapies including carbonic anhydrase inhibitors (e.g., acetazolamide) and/or topiramate.
Conservative Management: Centered on lifestyle modifications for weight reduction, alongside targeted medical therapies including carbonic anhydrase inhibitors (e.g., acetazolamide) and/or topiramate.
Sponsors
Sohag University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Months to 60 Months
Healthy volunteers
Yes
Inclusion criteria
* •Patients fulfilling modified Dandy criteria. * Age above 18 years. * Confirmed diagnosis of IIH: * Elevated opening pressure on lumbar puncture (\>25 cm H2o) in lateral decubitus position). * Unremarkable neuroimaging (MRI/MRV) ruling out mass lesions, hydrocephalus, or venous sinus thrombosis. * Presence of papilledema documented by a neuro-ophthalmologist.
Exclusion criteria
-Secondary causes of intracranial hypertension. (Evidence of an intracranial mass, hydrocephalus, or structural lesion on neuroimaging). * Cerebral venous sinus thrombosis. * Intracranial space occupying lesions. * Previous optic nerve diseases. * Severe systemic illness affecting vision. * Pregnancy (due to restricted medication options like Topiramate). * Previous intracranial surgery or CSF shunting procedures
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| visual outcome. | 6 months | * Visual Acuity (VA): Best-corrected visual acuity using the Snellen chart (converted to LogMAR for statistical analysis). * Funduscopy: Grading of papilledema using the Frisén Scale (Grades 0-5). * Visual Field Testing: Automated perimetry (Humphrey Visual Field, 24-2 or 30-2 program) to detect blind spot enlargement or peripheral field loss Optical Coherence Tomography (OCT): Measuring Retinal Nerve Fiber Layer (RNFL) thickness and total macular volume to objectively quantify axonal swelling. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Requirement for surgical intervention. | 6months | Surgical Interventions: Reserved for patients presenting with fulminant or progressive vision loss, or those exhibiting failure of maximal medical therapy. Surgical options include ventriculoperitoneal (VP) shunt, lumboperitoneal (LP) shunt |
Countries
Egypt
Outcome results
None listed