Idiopathic intracranial hypertension in men

B. B. Bruce, Sachin Kedar, G. P. Van Stavern, D. Monaghan, M. D. Acierno, R. A. Braswell, P. Preechawat, J. J. Corbett, N. J. Newman, V. Biousse

Research output: Contribution to journalArticle

126 Citations (Scopus)

Abstract

OBJECTIVE: To compare the characteristics of idiopathic intracranial hypertension (IIH) in men vs women in a multicenter study. METHODS: Medical records of all consecutive patients with definite IIH seen at three university hospitals were reviewed. Demographics, associated factors, and visual function at presentation and follow-up were collected. Patients were divided into two groups based on sex for statistical comparisons. RESULTS: We included 721 consecutive patients, including 66 men (9%) and 655 women (91%). Men were more likely to have sleep apnea (24% vs 4%, p < 0.001) and were older (37 vs 28 years, p = 0.02). As their first symptom of IIH, men were less likely to report headache (55% vs 75%, p < 0.001) but more likely to report visual disturbances (35% vs 20%, p = 0.005). Men continued to have less headache (79% vs 89%, p = 0.01) at initial neuro-ophthalmologic assessment. Visual acuity and visual fields at presentation and last follow-up were significantly worse among men. The relative risk of severe visual loss for men compared with women was 2.1 (95% CI 1.4-3.3, p = 0.002) for at least one eye and 2.1 (95% CI 1.1-3.7, p = 0.03) for both eyes. Logistic regression supported sex as an independent risk factor for severe visual loss. CONCLUSION: Men with idiopathic intracranial hypertension (IIH) are twice as likely as women to develop severe visual loss. Men and women have different symptom profiles, which could represent differences in symptom expression or symptom thresholds between the sexes. Men with IIH likely need to be followed more closely regarding visual function because they may not reliably experience or report other symptoms of increased intracranial pressure.

Original languageEnglish (US)
Pages (from-to)304-309
Number of pages6
JournalNeurology
Volume72
Issue number4
DOIs
StatePublished - Jan 27 2009

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Pseudotumor Cerebri
Headache
Sleep Apnea Syndromes
Intracranial Pressure
Visual Fields
Visual Acuity
Multicenter Studies
Medical Records
Logistic Models
Demography

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Bruce, B. B., Kedar, S., Van Stavern, G. P., Monaghan, D., Acierno, M. D., Braswell, R. A., ... Biousse, V. (2009). Idiopathic intracranial hypertension in men. Neurology, 72(4), 304-309. https://doi.org/10.1212/01.wnl.0000333254.84120.f5

Idiopathic intracranial hypertension in men. / Bruce, B. B.; Kedar, Sachin; Van Stavern, G. P.; Monaghan, D.; Acierno, M. D.; Braswell, R. A.; Preechawat, P.; Corbett, J. J.; Newman, N. J.; Biousse, V.

In: Neurology, Vol. 72, No. 4, 27.01.2009, p. 304-309.

Research output: Contribution to journalArticle

Bruce, BB, Kedar, S, Van Stavern, GP, Monaghan, D, Acierno, MD, Braswell, RA, Preechawat, P, Corbett, JJ, Newman, NJ & Biousse, V 2009, 'Idiopathic intracranial hypertension in men', Neurology, vol. 72, no. 4, pp. 304-309. https://doi.org/10.1212/01.wnl.0000333254.84120.f5
Bruce BB, Kedar S, Van Stavern GP, Monaghan D, Acierno MD, Braswell RA et al. Idiopathic intracranial hypertension in men. Neurology. 2009 Jan 27;72(4):304-309. https://doi.org/10.1212/01.wnl.0000333254.84120.f5
Bruce, B. B. ; Kedar, Sachin ; Van Stavern, G. P. ; Monaghan, D. ; Acierno, M. D. ; Braswell, R. A. ; Preechawat, P. ; Corbett, J. J. ; Newman, N. J. ; Biousse, V. / Idiopathic intracranial hypertension in men. In: Neurology. 2009 ; Vol. 72, No. 4. pp. 304-309.
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abstract = "OBJECTIVE: To compare the characteristics of idiopathic intracranial hypertension (IIH) in men vs women in a multicenter study. METHODS: Medical records of all consecutive patients with definite IIH seen at three university hospitals were reviewed. Demographics, associated factors, and visual function at presentation and follow-up were collected. Patients were divided into two groups based on sex for statistical comparisons. RESULTS: We included 721 consecutive patients, including 66 men (9{\%}) and 655 women (91{\%}). Men were more likely to have sleep apnea (24{\%} vs 4{\%}, p < 0.001) and were older (37 vs 28 years, p = 0.02). As their first symptom of IIH, men were less likely to report headache (55{\%} vs 75{\%}, p < 0.001) but more likely to report visual disturbances (35{\%} vs 20{\%}, p = 0.005). Men continued to have less headache (79{\%} vs 89{\%}, p = 0.01) at initial neuro-ophthalmologic assessment. Visual acuity and visual fields at presentation and last follow-up were significantly worse among men. The relative risk of severe visual loss for men compared with women was 2.1 (95{\%} CI 1.4-3.3, p = 0.002) for at least one eye and 2.1 (95{\%} CI 1.1-3.7, p = 0.03) for both eyes. Logistic regression supported sex as an independent risk factor for severe visual loss. CONCLUSION: Men with idiopathic intracranial hypertension (IIH) are twice as likely as women to develop severe visual loss. Men and women have different symptom profiles, which could represent differences in symptom expression or symptom thresholds between the sexes. Men with IIH likely need to be followed more closely regarding visual function because they may not reliably experience or report other symptoms of increased intracranial pressure.",
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N2 - OBJECTIVE: To compare the characteristics of idiopathic intracranial hypertension (IIH) in men vs women in a multicenter study. METHODS: Medical records of all consecutive patients with definite IIH seen at three university hospitals were reviewed. Demographics, associated factors, and visual function at presentation and follow-up were collected. Patients were divided into two groups based on sex for statistical comparisons. RESULTS: We included 721 consecutive patients, including 66 men (9%) and 655 women (91%). Men were more likely to have sleep apnea (24% vs 4%, p < 0.001) and were older (37 vs 28 years, p = 0.02). As their first symptom of IIH, men were less likely to report headache (55% vs 75%, p < 0.001) but more likely to report visual disturbances (35% vs 20%, p = 0.005). Men continued to have less headache (79% vs 89%, p = 0.01) at initial neuro-ophthalmologic assessment. Visual acuity and visual fields at presentation and last follow-up were significantly worse among men. The relative risk of severe visual loss for men compared with women was 2.1 (95% CI 1.4-3.3, p = 0.002) for at least one eye and 2.1 (95% CI 1.1-3.7, p = 0.03) for both eyes. Logistic regression supported sex as an independent risk factor for severe visual loss. CONCLUSION: Men with idiopathic intracranial hypertension (IIH) are twice as likely as women to develop severe visual loss. Men and women have different symptom profiles, which could represent differences in symptom expression or symptom thresholds between the sexes. Men with IIH likely need to be followed more closely regarding visual function because they may not reliably experience or report other symptoms of increased intracranial pressure.

AB - OBJECTIVE: To compare the characteristics of idiopathic intracranial hypertension (IIH) in men vs women in a multicenter study. METHODS: Medical records of all consecutive patients with definite IIH seen at three university hospitals were reviewed. Demographics, associated factors, and visual function at presentation and follow-up were collected. Patients were divided into two groups based on sex for statistical comparisons. RESULTS: We included 721 consecutive patients, including 66 men (9%) and 655 women (91%). Men were more likely to have sleep apnea (24% vs 4%, p < 0.001) and were older (37 vs 28 years, p = 0.02). As their first symptom of IIH, men were less likely to report headache (55% vs 75%, p < 0.001) but more likely to report visual disturbances (35% vs 20%, p = 0.005). Men continued to have less headache (79% vs 89%, p = 0.01) at initial neuro-ophthalmologic assessment. Visual acuity and visual fields at presentation and last follow-up were significantly worse among men. The relative risk of severe visual loss for men compared with women was 2.1 (95% CI 1.4-3.3, p = 0.002) for at least one eye and 2.1 (95% CI 1.1-3.7, p = 0.03) for both eyes. Logistic regression supported sex as an independent risk factor for severe visual loss. CONCLUSION: Men with idiopathic intracranial hypertension (IIH) are twice as likely as women to develop severe visual loss. Men and women have different symptom profiles, which could represent differences in symptom expression or symptom thresholds between the sexes. Men with IIH likely need to be followed more closely regarding visual function because they may not reliably experience or report other symptoms of increased intracranial pressure.

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