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Idiopathic Intracranial Hypertension

Ball, Alexandra K (2010)
M.D. thesis, University of Birmingham.

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Abstract

Idiopathic intracranial hypertension (IIH) is common in obese women and can lead to significant visual impairment. The cause of IIH is unknown and management controversial, due to the lack of prospective trials. This thesis provides a comprehensive review of the aetiology and management of IIH. The hypothesis that IIH is associated with a pro-inflammatory cytokine profile, suggested by its established association with female gender and obesity, was tested. Laboratory studies demonstrated the novel finding of elevated leptin in the cerebrospinal fluid from women with IIH, suggesting a role in the pathogenesis of IIH. The first randomised controlled trial in IIH is then reported. Treatment with acetazolamide was examined prospectively in 50 patients, providing seminal information to guide the design of future large-scale trials and data on the natural history of the condition. The observation that management of IIH is guided by a variety of clinical parameters was translated into a simple composite scoring system which was prospectively tested. Visual fields and optic disc appearance are shown to have the greatest influence on clinical outcome. Finally, a systematic study of the evaluation of papilloedema in IIH highlights the major limitations of the widely adopted Frisen staging scheme in the condition.

Type of Work:M.D. thesis.
Supervisor(s):Clarke, Carl E
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:Neurology
Subjects:RE Ophthalmology
RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Institution:University of Birmingham
ID Code:757
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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