EAN 2025 | Diagnosing idiopathic intracranial hypertension: blood versus CSF

Idiopathic intracranial hypertension is a very fascinating disorder. It is seen in young females that are obese or overweight, and it’s a neurometabolic disease, quite rare but we are seeing it more and more because of the pandemic of obesity. And it is not only a headache, it’s a severe headache that is very difficult to treat, but it is also related to visual symptoms and often they start with that, so they go to an optometrist or to an eye doctor and we see papilledema and that’s because of the pressure in the head. Because there’s increased pressure. It’s not due to a tumor, but it is an increased CSF secretion, CSF that covers the brain, but we don’t know the real reason behind that, what’s related to that, but we know that it has something to do with a metabolic disorder, a hormone disorder, and obesity. If they lose weight, the symptoms disappear or minimize. But it’s important to find them in the early stage before there is damage to their vision. Because if it has damage to the vision, we cannot repair it. Diagnosis can be difficult and we have just a series where we see that only one out of four that are referred for IIH actually have it so it’s important to identify the real group and also identify what’s wrong what’s the problem in the other group because it mimics also chronic migraine also related to obesity. So there’s an overlap there but it’s important to find the real IIH patients because it is urgent to treat them before their vision goes down or they have a permanent loss. So that’s one thing proper diagnosis and it can be difficult but also to find what is the reason for the headache because the headache can be very difficult it could be a daily headache and it really disables and burdens these young patients. So that was the reason for us to look in CSF, the cerebral spinal fluid, and pair it in the blood as well to see a newly diagnosed patient. And that means that they haven’t got any treatment as early as possible. We wanted to test that. That is a signal there that can help us to treat this headache to understand the disease. So that was why we took this, but it was the same in patients and in controls. But there was a clear relation what was in CSF and what was in blood. So it is demonstrated for the first time that we can… it’s easier, much easier with a blood sample than it is a CSF sample. But here we demonstrate that it was the same but there was no clear signal whether it’s the cause of the headache here. But we have to continue and maybe the antibodies, CGRP antibodies also have an effect here. There are some indications for that but but we couldn’t see it in newly diagnosed patients as we have here.

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