Gafoor VA, et al. – This prospective observational study aimed to investigate the treatment response of idiopathic intracranial hypertension (IIH) by serially measuring the cerebrospinal fluid (CSF) opening pressure and to describe the factors influencing the same. Treatment response was strongly associated with body mass index (BMI) in patients with IIH. However, patients with normal BMI were also shown to relapse and hence needed a continuous, long–term follow–up. In CSF pressure, the reduction attained in the first 3 months could reflect the long–term response to treatment.

• The authors conducted a prospective observational study in a cohort of 50 patients with IIH in whom CSF opening pressure was serially measured at pre-specified intervals.

• At baseline, the mean CSF opening pressure was 302.4 ± 51.69 mm of H2O (range: 220–410).
• The association was not significant (P = 0.168), even though a higher body mass index (BMI) demonstrated a trend toward a higher CSF opening pressure.
• However, the age of the patient had a significant negative correlation with the CSF pressure (P = 0.006).
• In CSF pressure, the maximum reduction occurred in the first 3 months of treatment, and thereafter it plateaued.
• In 12 (24%) patients, remission was attained.
• As per this study, BMI had the strongest relationship with remission (P = 0.001).