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.
