Clinical Characteristics of Patients With Idiopathic Intracranial Hypertension in China

Introduction Idiopathic intracranial hypertension (IIH) was previously assumed to be rare in Asia. However, it has been increasingly recognized in China in recent years, likely due to pandemic obesity and greater awareness of the condition. The clinical characteristics of IIH in Chinese patients remain unexplored. This study aims to investigate the clinical characteristics of patients with IIH in China. Methods A retrospective chart review of patients diagnosed with IIH at the First Affiliated Hospital of Zhengzhou University was conducted from January 2013 to July 2021. The analysis included demographic data, presenting symptoms, comorbidities, imaging features, laboratory data, intracranial pressure (ICP), treatment modalities, and outcomes. Results The study recruited 199 participants, including 145 females and 54 males, with a mean age at onset of 36 years (range: 27 to 45 years). The participants had a mean body mass index (BMI) of 26 kg/m2 (range: 23.4 to 29.4 kg/m2). Obesity was found in 67 participants (33.7%). The most common clinical symptom reported was headache, which was experienced by 118 (59.3%) participants, followed by decreased vision, which was reported by 115 (57.8%) participants. The main comorbidity among women was anemia (54, 37.2%), while men were more likely to have severe sleep apnea (7, 13%). The most common imaging features were perioptic nerve sheath distension (159, 79.9%) and transverse sinus stenosis (147, 73.9%). Symptoms were relieved with medication in 117 (58.8%) participants, while 72 (36.2%) underwent surgeries such as venous sinus stenting and ventriculoperitoneal shunt. During follow-up, symptoms resolved in 84 (42.2%) participants, while 115 (57.8%) participants experienced symptom improvement. The ratio of decreased vision was higher in females than in males. Conclusion The results provide valuable insights into the clinical features of IIH in this region. China appears to have a lower incidence of obesity compared to Western countries. Among comorbidities related to IIH, anemia and severe sleep apnea were the most common. A significant number of IIH patients underwent surgery. It was found that women had worse visual outcomes compared to men. Further investigation is needed to determine the most effective treatment for IIH in a larger cohort of Chinese patients.