Progress and Recognition of Idiopathic Intracranial Hypertension: A Narrative Review

Overview

Journal CNS Neurosci Ther

Specialties Neurology
Pharmacology

Date 2024 Aug 4

PMID 39097911

Authors

Chenxia Zhou

Yifan Zhou

Lu Liu

Huimin Jiang

Huimin Wei

Chen Zhou

Xunming Ji

Affiliations

Soon will be listed here.

Abstract

Background: Idiopathic intracranial hypertension (IIH) mainly affects obese young women, causing elevated intracranial pressure, headaches, and papilledema, risking vision loss and severe headaches. Despite weight loss as the primary treatment, the underlying mechanisms remain unclear. Recent research explores novel therapeutic targets.

Aims: This review aimed to provide a comprehensive understanding of IIH's pathophysiology and clinical features to inform pathogenesis and improve treatment strategies.

Methods: Recent publications on IIH were searched and summarized using PubMed, Web of Science, and MEDLINE.

Results: The review highlights potential pathomechanisms and therapeutic advances in IIH.

Conclusion: IIH incidence is rising, with growing evidence linking it to metabolic and hormonal disturbances. Early diagnosis and treatment remain challenging.

Citing Articles

Advances in GLP-1 receptor agonists for pain treatment and their future potential.

He Y, Xu B, Zhang M, Chen D, Wu S, Gao J J Headache Pain. 2025; 26(1):46.

PMID: 40016636 PMC: 11869436. DOI: 10.1186/s10194-025-01979-4.

Efficacy of Tirzepatide Dual GIP/GLP-1 Receptor Agonist in Patients With Idiopathic Intracranial Hypertension. A Real-World Propensity Score-Matched Study.

Azzam A, Essibayi M, Farkas N, Azab M, Morsy M, Elamin O Endocrinol Diabetes Metab. 2025; 8(2):e70019.

PMID: 39949069 PMC: 11825589. DOI: 10.1002/edm2.70019.

Contemporary Management of Cerebrospinal Fluid Rhinorrhoea: A Review of the Literature.

Mughal Z, Martinez-Devesa P, Boukas A, Jeyaretna S, Qureishi A J Clin Med. 2025; 14(3).

PMID: 39941665 PMC: 11818516. DOI: 10.3390/jcm14030995.

Epidemiological Patterns, Treatment Response, and Metabolic Correlations of Idiopathic Intracranial Hypertension: A US-Based Study From 1990 to 2024.

Azzam A, Nassar M, Morsy M, Mohamed A, Wu J, Essibayi M medRxiv. 2024; .

PMID: 39711710 PMC: 11661347. DOI: 10.1101/2024.12.08.24318685.

Efficacy of Tirzepatide Dual GIP/GLP-1 Receptor Agonist In Patients with Idiopathic Intracranial Hypertension. A Real-World Propensity Score-Matched Study.

Azzam A, Essibayi M, Farkas N, Azab M, Morsy M, Elamin O medRxiv. 2024; .

PMID: 39677436 PMC: 11643283. DOI: 10.1101/2024.11.12.24317193.

References

Seckl J . 11β-Hydroxysteroid dehydrogenase and the brain: Not (yet) lost in translation. J Intern Med. 2023; 295(1):20-37. DOI: 10.1111/joim.13741. View

Frisen L . Swelling of the optic nerve head: a staging scheme. J Neurol Neurosurg Psychiatry. 1982; 45(1):13-8. PMC: 491259. DOI: 10.1136/jnnp.45.1.13. View

Bruce B, Kedar S, Van Stavern G, Corbett J, Newman N, Biousse V . Atypical idiopathic intracranial hypertension: normal BMI and older patients. Neurology. 2010; 74(22):1827-32. PMC: 2882219. DOI: 10.1212/WNL.0b013e3181e0f838. View

Bruce B, Preechawat P, Newman N, Lynn M, Biousse V . Racial differences in idiopathic intracranial hypertension. Neurology. 2008; 70(11):861-7. PMC: 3010205. DOI: 10.1212/01.wnl.0000304746.92913.dc. View

Hasan-Olive M, Hansson H, Enger R, Nagelhus E, Eide P . Blood-Brain Barrier Dysfunction in Idiopathic Intracranial Hypertension. J Neuropathol Exp Neurol. 2019; 78(9):808-818. DOI: 10.1093/jnen/nlz063. View

Bruce B, Kedar S, Van Stavern G, Monaghan D, Acierno M, Braswell R . Idiopathic intracranial hypertension in men. Neurology. 2008; 72(4):304-9. PMC: 2677502. DOI: 10.1212/01.wnl.0000333254.84120.f5. View

Altiokka-Uzun G, Tuzun E, Ekizoglu E, Ulusoy C, Yentur S, Kurtuncu M . Oligoclonal bands and increased cytokine levels in idiopathic intracranial hypertension. Cephalalgia. 2015; 35(13):1153-61. DOI: 10.1177/0333102415570762. View

Mollan S, Mitchell J, Yiangou A, Ottridge R, Alimajstorovic Z, Cartwright D . Association of Amount of Weight Lost After Bariatric Surgery With Intracranial Pressure in Women With Idiopathic Intracranial Hypertension. Neurology. 2022; 99(11):e1090-e1099. PMC: 9536743. DOI: 10.1212/WNL.0000000000200839. View

Abbott S, Chan F, Tahrani A, Wong S, Campbell F, Parmar C . Weight Management Interventions for Adults With Idiopathic Intracranial Hypertension: A Systematic Review and Practice Recommendations. Neurology. 2023; 101(21):e2138-e2150. PMC: 10663033. DOI: 10.1212/WNL.0000000000207866. View

10.

Adderley N, Subramanian A, Nirantharakumar K, Yiangou A, Gokhale K, Mollan S . Association Between Idiopathic Intracranial Hypertension and Risk of Cardiovascular Diseases in Women in the United Kingdom. JAMA Neurol. 2019; 76(9):1088-1098. PMC: 6618853. DOI: 10.1001/jamaneurol.2019.1812. View

11.

MacAulay N, Toft-Bertelsen T . Dual function of the choroid plexus: Cerebrospinal fluid production and control of brain ion homeostasis. Cell Calcium. 2023; 116:102797. DOI: 10.1016/j.ceca.2023.102797. View

12.

Rohm T, Meier D, Olefsky J, Donath M . Inflammation in obesity, diabetes, and related disorders. Immunity. 2022; 55(1):31-55. PMC: 8773457. DOI: 10.1016/j.immuni.2021.12.013. View

13.

Westgate C, Botfield H, Alimajstorovic Z, Yiangou A, Walsh M, Smith G . Systemic and adipocyte transcriptional and metabolic dysregulation in idiopathic intracranial hypertension. JCI Insight. 2021; 6(10). PMC: 8262372. DOI: 10.1172/jci.insight.145346. View

14.

Wall M, McDermott M, Kieburtz K, Corbett J, Feldon S, Friedman D . Effect of acetazolamide on visual function in patients with idiopathic intracranial hypertension and mild visual loss: the idiopathic intracranial hypertension treatment trial. JAMA. 2014; 311(16):1641-51. PMC: 4362615. DOI: 10.1001/jama.2014.3312. View

15.

Tian Y, Zhang Z, Jing J, Dong K, Mo D, Wang Y . Anatomic Variation of the Lateral Sinus in Patients With Idiopathic Intracranial Hypertension: Delineation With Black-Blood Contrast-Enhanced MRI. Front Neurol. 2021; 12:715857. PMC: 8656160. DOI: 10.3389/fneur.2021.715857. View

16.

Mollan S, Subramanian A, Perrins M, Nirantharakumar K, Adderley N, Sinclair A . Depression and anxiety in women with idiopathic intracranial hypertension compared to migraine: A matched controlled cohort study. Headache. 2023; 63(2):290-298. PMC: 10952318. DOI: 10.1111/head.14465. View

17.

MacAulay N . Molecular mechanisms of brain water transport. Nat Rev Neurosci. 2021; 22(6):326-344. DOI: 10.1038/s41583-021-00454-8. View

18.

Ten Hove M, Friedman D, Patel A, Irrcher I, Wall M, McDermott M . Safety and Tolerability of Acetazolamide in the Idiopathic Intracranial Hypertension Treatment Trial. J Neuroophthalmol. 2015; 36(1):13-9. DOI: 10.1097/WNO.0000000000000322. View

19.

Xue X, Zhou C, Gao Y, Ji X, Zhang X . Optic nerve sheath fenestration for visual impairment in cerebral venous diseases. Front Neurol. 2023; 14:1065315. PMC: 9902767. DOI: 10.3389/fneur.2023.1065315. View

20.

West J, Greeneway G, Garner R, Aschenbrenner C, Singh J, Wolfe S . Correlation between angiographic stenosis and physiologic venous sinus outflow obstruction in idiopathic intracranial hypertension. J Neurointerv Surg. 2018; 11(1):90-94. DOI: 10.1136/neurintsurg-2018-014004. View