Clinical Characteristics of Idiopathic Intracranial Hypertension in Patients Over 50 Years of Age: A multicenter clinical cohort study.

ABSTRACT

PURPOSE: To characterize the clinical features of idiopathic intracranial hypertension (IIH) in patients >50 years of age compared to the typical IIH population and existing data for this older cohort. DESIGN: Retrospective, clinical cohort study. METHODS: Medical records of 65 patients >50 years of age at first diagnosis of IIH were reviewed based on the Modified Dandy Criteria from 4 academic centers. Each center provided randomly selected controls from IIH patients <50 years of age for each study patient at their location. Data recorded included patient demographics, presenting symptoms, medications, coexisting medical conditions, cerebrospinal fluid (CSF) opening pressure, treatments, and neuro-ophthalmic data from initial and final visits. RESULTS: Compared to controls, the older cohort showed the following characteristics fewer females (n = 51 [78.5%] vs. controls n = 60 [92.3%]; P = .045), fewer headaches (n = 33 [50.8%] vs. controls 52 [80.0%]; P = .001), more frequent incidental discoveries of papilledema (n = 19 [29.2%] vs. controls 7 [10.8%]; P = .015), and lower CSF opening pressure [median 33 cm H2O [range 21-58 cm H2O] vs. the median for controls 34 cm H2O [range 24-67 cm H2O; P = .029). CONCLUSIONS: Patients with IIH diagnosed at >50 years of age were less often female and had lower CSF opening pressure, fewer headaches, a higher chance of incidentally identified papilledema, and body mass index similar to that of younger IIH patients. Older IIH onset was not associated with worse visual outcome.