In response to Mutti et al. 2024 commentary on "Transient intracranial pressure elevations (B waves) associated with sleep apnea: the neglected role of cyclic alternating pattern".

The physiology of transient intracranial pressure (ICP) elevations (B waves), remains incompletely understood and appears to involve multiple mechanisms, including obstructive sleep apnea (OSA). Transient ICP elevations are associated with OSA and cyclic alternating pattern (CAP) metrics, suggesting a complex interplay between sleep fragmentation and ICP dynamics. Additionally, CAP metrics could complement standard OSA assessments, providing deeper insights into transient ICP fluctuations, particularly in conditions like normal-pressure hydrocephalus and idiopathic intracranial hypertension.

Stenting versus balloon angioplasty alone for idiopathic intracranial hypertension.

Background: Stenting is a common approach for treating idiopathic intracranial hypertension (IIH) and venous sinus stenosis (VSS). However, studies comparing stenting with balloon angioplasty alone are lacking. This study sought to compare the clinical efficacy of balloon angioplasty and stenting in the treatment of IIH and VSS.

The ligamentous cervical instability etiology of human disease from the forward head-facedown lifestyle: emphasis on obstruction of fluid flow into and out of the brain.

Ligamentous cervical instability, especially ligamentous upper cervical instability, can be the missing structural cause and/or co-morbidity for many chronic disabling brain and systemic body symptoms and diagnoses. Due to the forward head-facedown lifestyle from excessive computer and cell phone usage, the posterior ligament complex of the cervical spine undergoes a slow stretch termed "creep" which can, over time, lead to cervical instability and a breakdown of the cervical curve. As this degenerative process continues, the cervical curve straightens and ultimately becomes kyphotic, a process called cervical dysstructure; simultaneously, the atlas (C1) moves forward, both of which can lead to encroachment of the structures in the carotid sheath, especially the internal jugular veins and vagus nerves.

Cardiometabolic Outcomes in Idiopathic Intracranial Hypertension: An International Matched-Cohort Study.

Introduction: Idiopathic intracranial hypertension (IIH) has been traditionally viewed as a neuro-ophthalmic disorder, yet emerging evidence suggests broader systemic implications. Our study investigates the cardiometabolic outcomes associated with IIH through a comprehensive matched-cohort analysis.

Methods: We conducted a retrospective analysis of electronic health records from 2009 to 2024.

Semaglutide as an Adjunctive Therapy to Standard Management for Idiopathic Intracranial Hypertension: A Real-World Data-Based Retrospective Analysis.

Background: Idiopathic intracranial hypertension (IIH) is a neurological disorder characterized by elevated intracranial pressure, predominantly affecting young women with obesity. This study evaluates the effectiveness of semaglutide as an adjunctive therapy to standard IIH management using real-world data.

Methods: We conducted a retrospective cohort analysis comparing IIH patients receiving semaglutide plus standard therapy versus standard therapy alone.

Efficacy of Tirzepatide Dual GIP/GLP-1 Receptor Agonist In Patients with Idiopathic Intracranial Hypertension. A Real-World Propensity Score-Matched Study.

Introduction: Idiopathic intracranial hypertension (IIH) is a neurological disorder characterized by elevated intracranial pressure, predominantly affecting obese women of reproductive age. While GLP-1 receptor agonists have shown promise in IIH management, the potential of dual GIP/GLP-1 receptor activation through tirzepatide remains unexplored. This study aimed to evaluate tirzepatide's efficacy as an adjunctive therapy in IIH management.

Children with MOG-IgG positive bilateral optic neuritis misdiagnosed as fulminant idiopathic intracranial hypertension.

Background: Fulminant idiopathic intracranial hypertension (IIH) is characterized by headache, rapid decrease of vision and elevated CSF-opening pressure.

Objective: To delineate a subgroup of MOGAD mimicking fulminant IIH.

Methods: In this case series children with MOGAD with vision loss, optic disc swelling and elevated CSF opening pressure, initially diagnosed with fulminant IIH, were included.

Special Considerations in the Treatment of Idiopathic Intracranial Hypertension.

Purpose Of Review: To review the management of Idiopathic Intracranial Hypertension (IIH) with co-existing conditions affecting therapy: obesity, sulfa allergy, nephrolithiasis, and pregnancy.

Recent Findings: The IIH-WT trial showed that bariatric surgery is currently the most effective method for obese patients with IIH to lose weight, leading to normalization of CSF pressure in many cases. Allergy to sulfonamide antibiotics does not preclude the use of acetazolamide; rather, penicillin allergy or multiple drug allergies are the strongest predictor of a hypersensitivity reaction.

Factors Influencing Favourable Clinical Outcomes in Idiopathic Intracranial Hypertension with Venous Sinus Stenosis Stenting.

Purpose: This study aimed to investigate the factors influencing favourable clinical outcomes in idiopathic intracranial hypertension (IIH) patients with venous sinus stenosis (VSS) who received stenting treatment.

Methods: In this prospective cohort study, we analyzed a total of 172 IIH patients with VSS treated with venous sinus stenting. Clinical outcomes were categorized as either "complete resolved" or "improved".

Idiopathic Intracranial Hypertension - How Can Orthoptists Help Improve Care?

Care for people with idiopathic intracranial hypertension (IIH) needs improving and I think orthoptists are in a perfect position to help.   People with fulminant IIH are still losing sight due to delayed diagnosis or mismanagement.People with IIH often have a poor quality of life due to disabling chronic headaches and poor mental health.

Intracranial hypertension as the first manifestation of systemic lupus erythematosus: A case report.

Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple systems and organs, including the central and peripheral nervous systems. Papilledema and idiopathic intracranial hypertension, in the absence of space-occupying lesions or other detectable causes, is a rare manifestation. We report the case of a young woman with chronic headache, papilledema, and intracranial hypertension on examination, in whom a de novo diagnosis of systemic lupus erythematosus and class V lupus nephritis was made.

Dural arteriovenous fistula (DAVF) after venous sinus stent (VSS) for presumed idiopathic intracranial hypertension (IIH): A case report and literature review.

Dural arteriovenous fistulas (DAVFs) are rare but significant intracranial vascular malformations that are usually idiopathic and can lead to severe complications like venous hypertension and intracranial hemorrhage. We present 2 cases of DAVF occurring after venous sinus stenting (VSS) for presumed idiopathic intracranial hypertension (IIH) in a 51-year-old and a 52-year-old female. In both patients, Cognard type 1 DAVF was detected by Catheter angiography and successfully obliterated with Onyx™ embolization.