Work

Epidemiology, pharmacological treatment and invasive management of idiopathic intracranial hypertension in Austria: a nationwide, hospital-based, controlled analysis of insurance data

Year: 2026

Type: article

Abstract: QUESTION/OBJECTIVE: Idiopathic intracranial hypertension (IIH) is a rare disorder characterized by headaches and papilledema. In this nationwide, hospital-based, controlled analysis of insurance data, we aimed at investigating IIH prevalence and treatment patterns. METHODS: The Austrian health insurance register was queried for patients discharged between 2016 and 2021 with an ICD-10 diagnosis of G93.2 and/or prescription of acetazolamide (AZM). Study inclusion required both ≥ 2 assignments of G93.2 and ≥ 1 dispensation of AZM. For each IIH patient, age- and sex-matched obese controls (OBC, ICD-10: E65/66/68) and general population controls (GPC) were drawn. We then extracted all medication collected and procedures performed during the study period. RESULTS: Of 5,969 patients identified, 114 met the inclusion criteria, yielding an estimated hospital-based IIH prevalence of 4.77 per 100,000 discharges in total and 7.88 per 100,000 female discharges. IIH patients had the highest rates of AZM (100% vs. 0% vs. 0%), topiramate (39.5% vs. 2.6% vs. 0.9%), furosemide (18.4% vs. 5.3% vs. 0.9%), lumbar puncture (11.4% vs. 0% vs. 0%), and ventriculoperitoneal shunting (18.4% vs. 0% vs. 0%) compared with OBC and GPC. In contrast, bariatric surgery was less common in IIH than in OBC (4.4% vs. 31.6%; 0% in GPC). CONCLUSIONS: The estimated prevalence falls within reported ranges for Central Europe while likely underestimating the prevalence due to reliance on hospital discharge data. Treatment patterns generally reflect guideline-based management, although invasive procedures appear overrepresented because hospital data skew towards severe cases. Bariatric surgery is underutilized in patients with IIH compared to those with obesity alone.

Source: The Journal of Headache and Pain

DOI: 10.1186/s10194-026-02336-9