Rigmor Jensen, Sajedeh Efthekari, Connar Westgate, Ida Israelsen, Johanne Korsbaek, Vlasta Vukovic Cvetkovic, Hanne Yri and Nadja Skadkær Hansen
Idiopathic intracranial hypertension (IIH) is an intriguing, clinical condition of increased intracranial pressure without pathological, laboratory or radiological evidence of intra¬cranial pathology in young, obese individuals. The clinical symptoms are severe headache, pulsatile tinnitus, transitory visual obscurations and diplopia. Demographic studies report a rapidly increasing incidence of IIH in obese young females and with increasing pandemic obesity a significant increase in the number of IIH patients in Denmark can be predicted. Severe obesity is closely related to a number of neuroendocrinological changes which still have not been evaluated in IIH. Untreated IIH may lead to severe visual loss and blindness resulting from damage to the optic nerve and chronic disabling headache.
A specialized clinical and scientific IIH team is established with neuro-ophthalmologist, neurologists, dietist and basis scientist. A PhD study from our group has analyzed the clinical presentation in more than 40 patients detailing their headache characteristics, provided new suggestions for headache criteria and tested the cognitive function before and after treatment. Currently, a PhD study is investigating new diagnostic and prognostic markers for the disease. This includes establishment of a biobank, investigations of the use of imaging (MRI) and ultrasound to diagnose the condition and investigations of possible risk factors associated with a more severe prognosis. The current analyses related to the biobank (cerebrospinal fluid and blood) focuses on identifying and characterizing new, possible markers related to IIH, metabolism, obesity and neurodegeneration. A new, randomized controlled trial to investigate weight loss strategies in patients with recently diagnosed IIH is being planned.
A group of researchers investigating the basic mechanisms of IIH has been established at the research park in Glostrup. The group has developed a reliable novel animal model for measuring the intracranial pressure over longer periods of time in awake, freely moving rats. The group is using this animal model til investigate disease pathophysiology and carry out pharmacological testing of potential treatment targets.
Using this highly specialized, translational approach with close collaboration between clinical and basic researchers we continue the search for a better understanding of CSF dynamics and IIH.
Long term follow-up of patients with idiopathic intracranial hypertension, ophthalmological and neurobiological aspects.
Diagnostic and prognostic biomarkers in idiopathic intracranial hypertension (serum, cerebrospinal fluid, imaging).
Experimental models of idiopathic intracranial hypertension and mechanisms of water transport in the brain.
Weight loss management in recently diagnosed IIH.
Steffen Hamann & Marianne Wegener, Department of Opthalmology, Rigshospitalet; Alexandra Sinclair & her CSF-research group, University of Birmingham, UK and Nanna MacAulay, University of Copenhagen.