Analysis of Clinical Features and Ultrasonographic Manifestations of Idiopathic Intracranial Hypertension
Objective To analyze the clinical characteristics of idiopathic intracranial hypertension(IIH)and summarize the related ultrasonographic manifestations.Methods A total of 32 patients with IIH hospitalized in the Department of Emergency Neurology,Xuanwu Hospital,Capital Medical University from July 2021 to June 2023 were retrospectively enrolled.Baseline data(age,gender,height,BMI,intracranial pressure),clinical manifestations,MRV or DSA and ultrasound examination parameters(internal diameter and blood flow of internal jugular vein,optic nerve sheath diameter,optic disc height,etc.)of patients were collected,and the data were analyzed and summarized.Results ①A total of 32 patients were enrolled in this study,with age of(32.0±10.6)years,male to female ratio of 9∶23,height of(162.0±8.3)cm,BMI of 27.5(24.0-31.8)kg/m2,and intracranial pressure of 330.0(300.0-396.3)mmHg(1 mmHg=0.133 kPa).②The clinical manifestations of the enrolled patients were headache in 16 cases(50.0％),blurred vision in 16 cases(50.0％),nausea and vomiting in 12 cases(37.5％),dizziness in 6 cases(18.8％),tinnitus and intracranial tinnitus in 6 cases(18.8％).③Among the 32 enrolled patients,16 cases(50.0％)had diabetes mellitus,13 cases(40.6％)had hyperlipidemia,7 cases(21.9％)had hypertension,4 cases(12.5％)had obstructive sleep apnea syndrome,and 2 cases(6.3％)had spontaneous cerebrospinal fluid leakage.Among the 23 female patients,5 cases(21.7％)were complicated with polycystic ovary syndrome.④The diameter of the optic nerve sheath was 4.92(4.90-5.09)mm,and the height of the optic disc was 0.83(0-1.28)mm.⑤According to MRV or DSA results,there were 7 cases(21.9％)of cerebral venous sinus stenosis,including 5 cases(15.6％)of right cerebral venous sinus stenosis and 2 cases(6.3％)of left cerebral venous sinus stenosis.⑥In the non-stenosis group,the internal diameters of J2 and J3 segments of the right internal jugular vein were larger than those of J2 and J3 segments of the left internal jugular vein[(6.48±1.69)mm vs.(5.63±1.10)mm,P=0.006;(4.62±1.44)mm vs.(3.42±0.88)mm,P＜0.001].The blood flow in J2 and J3 segments of the right internal jugular vein was greater than that in J2 and J3 segments of the left internal jugular vein[(376.8±172.8)mL/min vs.(229.6±93.3)mL/min,(214.4±104.0)mL/min vs.(115.2±62.9)mL/min,all P＜0.001].In the cerebral venous sinus stenosis group,the internal diameter of the J3 segment on the narrow side of the internal jugular vein was smaller than that on the healthy side[(3.23±1.05)mm vs.(3.99±1.25)mm,P=0.011].The blood flow in the J3 segment on the narrow side of the internal jugular vein was lesser than that on the healthy side[(91.4±68.7)mL/min vs.(192.9±87.9)mL/min,P=0.004].Conclusions The results showed that IIH was closely related to obesity,and was associated with a higher incidence of polycystic ovary syndrome,spontaneous cerebrospinal fluid leakage,obstructive sleep apnea syndrome,hypertension,hyperlipidemia,diabetes mellitus,and cerebral venous sinus stenosis.Meanwhile,the internal diameter and blood flow in the J3 segment on the narrow side of the internal jugular vein were smaller than those on the healthy side.IIH causes a widening of the optic nerve sheath diameter and an increase in the height of the optic disc.
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