The course of headache in idiopathic intracranial hypertension: a 12‐month prospective follow‐up study

Yri, H; Rönnbäck, Cecilia; Wegener, Marianne; Hamann, Steffen; Jensen, Rigmor Højland

doi:10.1111/ene.12512

Cited by 79 publications

(78 citation statements)

References 22 publications

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“…In our IIH populations of 44 and 40 patients, respectively, the visual function were almost normalized in all subjects after 12 months whereas the major long-term complications were headache and impaired cognition [Yri et al 2014b;Yri et al 2012]. Despite the severe headache and a potential treat to visual function, compliance to treatment and follow-up is surprisingly poor.…”

Section: Headache Management and Prognosismentioning

confidence: 71%

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The diagnosis and management of idiopathic intracranial hypertension and the associated headache

Jensen

Radojičić

Yri

2016

Ther Adv Neurol Disord

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Idiopathic intracranial hypertension (IIH) is a challenging disorder with a rapid increasing incidence due to a close relation to obesity. The onset of symptoms is often insidious and patients may see many different specialists before the IIH diagnosis is settled. A summary of diagnosis, symptoms, headache characteristics and course, as well as existing evidence of treatment strategies is presented and strategies for investigations and management are proposed.

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Section: Headache Management and Prognosismentioning

confidence: 71%

“…In the recent study predictors for a favorable outcome of headache 12 months after diagnosis were younger age at onset and a high diagnostic opening pressure. This may relate to an early diagnosis or fast initiation of relevant treatment in these patients [Yri et al 2014b]. …”

Section: Headache Management and Prognosismentioning

confidence: 99%

The diagnosis and management of idiopathic intracranial hypertension and the associated headache

Jensen

Radojičić

Yri

2016

Ther Adv Neurol Disord

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“…Many IIH patients have persistent headache despite normalized intracranial pressure 11 . A recent prospective study similarly found that 57% of patients with IIH had sustained, long-term headache despite resolution of papilledema 12 . Likewise, studies of CSF shunting for IIH elated headaches confirm the notion that long-term headache control is frequently independent of CSF pressure management with a 50% headache recurrence rate in three years 13 .…”

Section: Discussionmentioning

confidence: 94%

Headache in Idiopathic Intracranial Hypertension: Findings From the Idiopathic Intracranial Hypertension Treatment Trial

et al. 2017

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Objective To characterize the phenotype, headache-related disability, medical co-morbidities, use of symptomatic headache medications, and headache response to study interventions in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT). Methods Patients with untreated IIH and mild vision loss enrolled in the IIHTT and randomized to acetazolamide (ACZ) and weight loss or placebo (PLB) and weight loss had prospective assessment of headache disability using the Headache Impact Test 6 (HIT-6) questionnaire. Subjects with headache at the baseline visit were assigned a headache phenotype using the International Classification for Headache Disorders version 3 beta (ICHD-3b). Medication overuse was determined using the participants’ reported medication use for the preceding month and ICHD-3b thresholds for diagnosing medication overuse headache. We investigated relationships between headache disability and various other clinical characteristics at baseline and at six months. Results Headache was present in 139 (84%) of the 165 enrollees at baseline. The most common headache phenotypes were migraine (52%), tension type headache (22%), probable migraine (16%), and probable tension type headache (4%). Fifty-one (37%) participants overused symptomatic medications at baseline, most frequently simple analgesics. A similar amount of improvement in the adjusted mean (± standard error) HIT-6 score occurred in the ACZ (−9.56 ± 1.05) and PLB groups (−9.11 ± 1.14) at six months (group difference −0.45, 95% CI −3.50 to 2.60, p=0.77). Headache disability did not correlate with any of the studies headache parameters, which included: the lumbar puncture opening pressure at baseline or at six months, body mass index, the amount of weight lost, papilledema grade, perimetric mean deviation, or the use of hormonal contraception. Headache disability was significantly associated with patient-reported quality of life in the physical, mental, and visual domains. Conclusions Headache was common, of varied character, disabling, and associated with poorer quality of life in our cohort of patients with mild visual impairment. The lack of correlation between headache disability and cerebrospinal fluid (CSF) pressure at baseline and at the end of the randomized phase of the study implies that headache in IIH may be related to factors other than intracranial hypertension, and that specific headache treatment is needed in addition to therapies directed at lowering CSF pressure.

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“…Features consistent with migraine, including unilateral throbbing, with nausea and photophobia are also reported 44. Back pain, neck pain and radicular pain frequently occur 45…”

Section: Clinical Featuresmentioning

confidence: 99%

Evolving evidence in adult idiopathic intracranial hypertension: pathophysiology and management

Mollan

Ali

Hassan-Smith

et al. 2016

J Neurol Neurosurg Psychiatry

177

153

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Idiopathic intracranial hypertension (IIH) is a rare but important disease associated with significant morbidity. There is an expected rise in prevalence in line with the escalating global burden of obesity. Modern revisions in the terminology and diagnostic criteria for IIH help guide clinicians in investigations and researchers in standardising recruitment criteria for clinical trials. The pathophysiology of IIH is incompletely characterised; suggested underpinning mechanisms include the role of cerebrospinal fluid regulation as well as metabolic and endocrinological perspectives. Recent treatment trials are providing insights into the management but debate still surrounds key areas in treatment. This review will provide an up-to-date discussion on the potential pathogenic mechanisms and management of IIH.

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The course of headache in idiopathic intracranial hypertension: a 12‐month prospective follow‐up study

Cited by 79 publications

References 22 publications

The diagnosis and management of idiopathic intracranial hypertension and the associated headache

The diagnosis and management of idiopathic intracranial hypertension and the associated headache

Headache in Idiopathic Intracranial Hypertension: Findings From the Idiopathic Intracranial Hypertension Treatment Trial

Evolving evidence in adult idiopathic intracranial hypertension: pathophysiology and management

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