ABSTRACT
Background and aims: Idiopathic Intracranial Hypertension (IIH) is caused by elevated cerebrospinal fluid pressure of unknown aetiology predominantly affecting obese women of childbearing age. This study looked into the management of this patient population in a country with a rising obesity rate. Methods: Patients diagnosed with IIH were identified through the national Maltese database and further data was retrospectively collected from patients' files. Results: 59 patients were identified with an average age of 34 (14-68yr), and BMI 36.3 (26.7-49.1). Most underwent repeated lumbar punctures (Graph 1). The average opening pressure was 31.71cm of water (17-72cm of water). Visual field testing (75%), fundal photos (44%) and optical coherence tomography (21%) were often employed to assess papilledema. MRI showed typical IIH changes in 75% (Table 1). All patients were started on acetazolamide. Magnitude and specific strategies for weight loss were not routinely documented. 17% were offered surgical management;including shunt insertion (15%), and dural venous sinus stenting (5%). (Figure Presented) Conclusion: With rising obesity rates, this has become an increasingly prevalent disorder. Moreover, several patients either presented or relapsed following weight gain at the beginning of the COVID-19 pandemic. This study confirmed that more focus should be employed towards weight loss, which was often poorly documented and not aggressively targeted. Patients were undergoing frequent lumbar punctures rather than repeat, non-invasive ophthalmological investigations - this was tackled locally by involving an ophthalmologist with a special interest in the disorder. A multidisciplinary task force and new local guidelines have been instrumental in standardising and optimising management for these patients.