J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Original Article

Volume 16, Number 2-3, March 2024, pages 118-123

Headache Phenotypes in Idiopathic Intracranial Hypertension and Its Short-Term Outcomes: A Retrospective Case Series Study

**Table 1.** Demographic and Clinical Characteristics at Time of Diagnosis of the 32 Patients Included
Characteristics
CSF: cerebrospinal fluid; IIH: idiopathic intracranial hypertension; IQR: interquartile range.
Median age (years)	29.0 (IQR 25.0 - 38.5)
Female sex	29 (90.6%)
Median body mass index (kg/m²)	32.5 (IQR 27.9 - 35.0)
Idiopathic intracranial hypertension characteristics
Papilledema	28 (87.5%)
Median CSF opening pressure (cm H₂O)	36.5 (IQR 29.0 - 45.3)
Radiological aspects suggestive of IIH	14 (43.8%)
Transient visual obscurations	14 (43.8%)
Diplopia	10 (31.3%)
Tinnitus	10 (31.3%)
VI nerve palsy	6 (18.8%)
Headache characteristics
Migraine phenotype	11 (34.4%)
Tension-type phenotype	9 (28.1%)
Unclassifiable phenotype	12 (37.5%)
Acute headache	17 (53.1%)
Subacute headache	2 (6.3%)
Chronic headache	5 (15.6%)
Intermittent headache	8 (25.0%)
Daily headache	24 (75.0%)
Nausea and vomiting	6 (18.8%)
Photophobia	15 (46.9%)
Phonophobia	3 (9.4%)
Analgesic overuse	3 (9.4%)
History of previous primary headache	13 (40.6%)

Table 1. Demographic and Clinical Characteristics at Time of Diagnosis of the 32 Patients Included

Characteristics

CSF: cerebrospinal fluid; IIH: idiopathic intracranial hypertension; IQR: interquartile range.

Median age (years)

29.0 (IQR 25.0 - 38.5)

Female sex

29 (90.6%)

Median body mass index (kg/m²)

32.5 (IQR 27.9 - 35.0)

Idiopathic intracranial hypertension characteristics

Papilledema

28 (87.5%)

Median CSF opening pressure (cm H₂O)

36.5 (IQR 29.0 - 45.3)

Radiological aspects suggestive of IIH

14 (43.8%)

Transient visual obscurations

14 (43.8%)

Diplopia

10 (31.3%)

Tinnitus

10 (31.3%)

VI nerve palsy

6 (18.8%)

Headache characteristics

Migraine phenotype

11 (34.4%)

Tension-type phenotype

9 (28.1%)

Unclassifiable phenotype

12 (37.5%)

Acute headache

17 (53.1%)

Subacute headache

2 (6.3%)

Chronic headache

5 (15.6%)

Intermittent headache

8 (25.0%)

Daily headache

24 (75.0%)

Nausea and vomiting

6 (18.8%)

Photophobia

15 (46.9%)

Phonophobia

3 (9.4%)

Analgesic overuse

3 (9.4%)

History of previous primary headache

13 (40.6%)

**Table 2.** Treatment Characteristics and Outcomes of the 32 Patients Included
Treatment and outcomes
Therapies proposed
Weight loss	29 (90.6%)
Pharmacological treatment	30 (93.8%)
Acetazolamide alone	16 (50.0%)
Acetazolamide and subsequent topiramate	10 (31.3%)
Acetazolamide and subsequent furosemide	1 (3.1%)
Acetazolamide and subsequent corticotherapy	2 (6.3%)
Surgical treatment	14 (43.8%)
Ventriculoperitoneal shunt	13 (40.6%)
Optic nerve fenestration	1 (3.1%)
12 months follow-up
Initial medical treatment failure	14 (43.8%)
Papilledema improvement	25 (78.1%)
≥ 50% improvement in headache frequency	20 (62.5%)

Table 2. Treatment Characteristics and Outcomes of the 32 Patients Included

Treatment and outcomes

Therapies proposed

Weight loss

29 (90.6%)

Pharmacological treatment

30 (93.8%)

Acetazolamide alone

16 (50.0%)

Acetazolamide and subsequent topiramate

10 (31.3%)

Acetazolamide and subsequent furosemide

1 (3.1%)

Acetazolamide and subsequent corticotherapy

2 (6.3%)

Surgical treatment

14 (43.8%)

Ventriculoperitoneal shunt

13 (40.6%)

Optic nerve fenestration

1 (3.1%)

12 months follow-up

Initial medical treatment failure

14 (43.8%)

Papilledema improvement

25 (78.1%)

≥ 50% improvement in headache frequency

20 (62.5%)

**Table 3.** Headache Phenotypes and Differences in Clinical and Outcome Variables
Variables	Migraine (n = 11)	Tension-type (n = 9)	Unclassifiable (n = 12)	P-value
*Statistically significant P-value. CSF: cerebrospinal fluid; IIH: idiopathic intracranial hypertension; IQR: interquartile range.
Median age (years)	28.0 (IQR 18.0 - 42.0)	33.0 (IQR 29.5 - 50.5)	26.5 (IQR 25.0 - 29.8)	0.060
Median time to diagnosis (months)	3.0 (IQR 1.8 - 8.0)	12.0 (IQR 0.5 - 12.0)	0.8 (IQR 0.4 - 1.4)	0.153
Median body mass index (kg/m²)	32.5 (IQR 28.8 - 33.8)	32.5 (IQR 32.0 - 33.9)	31.3 (IQR 27.0 - 37.0)	0.725
Median CSF opening pressure (cm H₂O)	33.0 (IQR 30.0 - 40.3)	30.0 (IQR 28.0 - 45.0)	43.0 (IQR 29.8 - 50.0)	0.343
Papilledema	11 (34.4%)	8 (25.0%)	9 (28.1%)	0.192
Radiological aspects suggestive of IIH	6 (18.8%)	3 (9.4%)	5 (15.6%)	0.625
Transient visual obscurations	5 (15.6%)	4 (12.5%)	5 (15.6%)	0.982
Diplopia	3 (9.4%)	0 (0.0%)	7 (21.9%)	0.016*
Tinnitus	3 (9.4%)	1 (3.1%)	6 (18.8%)	0.154
VI nerve palsy	2 (6.3%)	0 (0.0%)	4 (12.5%)	0.153
Analgesic overuse	0 (0.0%)	1 (3.1%)	2 (6.3%)	0.383
History of previous primary headache	5 (15.6%)	2 (6.3%)	6 (18.8%)	0.401
Initial medical treatment failure	5 (15.6%)	3 (9.4%)	6 (18.8%)	0.741
≥ 50% improvement in headache frequency at 1 month	3 (9.4%)	5 (15.6%)	6 (18.8%)	0.384
≥ 50% improvement in headache frequency at 3 months	5 (15.6%)	5 (15.6%)	5 (15.6%)	0.814
≥ 50% improvement in headache frequency at 6 months	6 (18.8%)	6 (18.8%)	7 (21.9%)	0.856
≥ 50% improvement in headache frequency at 12 months	6 (18.8%)	6 (18.8%)	8 (25.0%)	0.798

Table 3. Headache Phenotypes and Differences in Clinical and Outcome Variables

Variables

Migraine (n = 11)

Tension-type (n = 9)

Unclassifiable (n = 12)

P-value

*Statistically significant P-value. CSF: cerebrospinal fluid; IIH: idiopathic intracranial hypertension; IQR: interquartile range.

Median age (years)

28.0 (IQR 18.0 - 42.0)

33.0 (IQR 29.5 - 50.5)

26.5 (IQR 25.0 - 29.8)

0.060

Median time to diagnosis (months)

3.0 (IQR 1.8 - 8.0)

12.0 (IQR 0.5 - 12.0)

0.8 (IQR 0.4 - 1.4)

0.153

Median body mass index (kg/m²)

32.5 (IQR 28.8 - 33.8)

32.5 (IQR 32.0 - 33.9)

31.3 (IQR 27.0 - 37.0)

0.725

Median CSF opening pressure (cm H₂O)

33.0 (IQR 30.0 - 40.3)

30.0 (IQR 28.0 - 45.0)

43.0 (IQR 29.8 - 50.0)

0.343

Papilledema

11 (34.4%)

8 (25.0%)

9 (28.1%)

0.192

Radiological aspects suggestive of IIH

6 (18.8%)

3 (9.4%)

5 (15.6%)

0.625

Transient visual obscurations

5 (15.6%)

4 (12.5%)

5 (15.6%)

0.982

Diplopia

3 (9.4%)

0 (0.0%)

7 (21.9%)

0.016*

Tinnitus

3 (9.4%)

1 (3.1%)

6 (18.8%)

0.154

VI nerve palsy

2 (6.3%)

0 (0.0%)

4 (12.5%)

0.153

Analgesic overuse

0 (0.0%)

1 (3.1%)

2 (6.3%)

0.383

History of previous primary headache

5 (15.6%)

2 (6.3%)

6 (18.8%)

0.401

Initial medical treatment failure

5 (15.6%)

3 (9.4%)

6 (18.8%)

0.741

≥ 50% improvement in headache frequency at 1 month

3 (9.4%)

5 (15.6%)

6 (18.8%)

0.384

≥ 50% improvement in headache frequency at 3 months

5 (15.6%)

0.814

≥ 50% improvement in headache frequency at 6 months

6 (18.8%)

7 (21.9%)

0.856

≥ 50% improvement in headache frequency at 12 months

6 (18.8%)

8 (25.0%)

0.798