Author Block: Wesley Chan, Laine Green, Anuradha Mishra, Charles Maxner, Jai J. Shankar

Author Disclosure Block: W. Chan: None. L. Green: None. A. Mishra: None. C. Maxner: None. J.J. Shankar: None.

Abstract Body:

Purpose: Idiopathic intracranial hypertension (IIH) is characterized by increased intracranial pressure resulting in potentially irreversible vision loss and headaches. IIH primarily affects overweight women of child-bearing age with an incidence of 19 in 100,000. Ninety percent of patients with IIH have transverse venous sinus stenosis (TVSS) on contrast enhanced magnetic resonance venography (CEMRV) of the brain. Whether TVSS causes IIH or is an effect of the increased intracranial pressures is controversial. The aim of this study is to examine the feasibility of prospectively observing TVSS in patients with IIH from diagnosis, through treatment, and on follow up. Study Design: Prospective observational cohort study 

Methods: Patients diagnosed with IIH and TVSS on their CEMRV were recruited to the study over a one-year period. All patients received brain magnetic resonance imaging (MRI) with CEMRV and a lumbar puncture (LP) as part of their diagnosis for IIH. Patients were medically managed and followed with a CEMRV immediately following LP, 3-6 months after diagnosis with resolution of IIH symptoms, and one year after diagnosis. Ophthalmological data were collected at the time of diagnosis, 3-6 months, and one year after diagnosis. Feasibility data including patient recruitment rate, barriers, and logistical issues were recorded. 

Results: A total of 20 suspected IIH patients were screened during a one-year study period and were followed over another year. Five of seven (71.4%; 95% CI: 36.21-100) patients were successfully enrolled. Thirteen patients did not meet study eligibility criteria, one declined participation, and one withdrew from the study. All recruited patients had clinical resolution of their IIH on medical therapy and none of them had any significant change in their TVSS. 

Conclusions: It is feasible to prospectively examine TVSS in patients with IIH. All patients with IIH in our study improved clinically on medical management but none of them showed significant changes in their TVSS. A larger multi-centre prospective study would be beneficial to confirm our findings.