Factors Associated with Subsequent Lumboperitoneal Shunt Requirement in Adult Women with Idiopathic Intracranial Hypertension: A Prospective Cohort Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Cerebrospinal fluid (CSF) diversion may be required in idiopathic intracranial hypertension (IIH) when medical therapy fails or vision deteriorates. Early identification of patients likely to require shunting may facilitate timely neurosurgical referral. This study aimed to identify baseline factors associated with lumboperitoneal (LP) shunt requirement in adults with IIH. Methods: This prospective observational cohort study included 40 female patients aged 18–50 years. All initially received conservative medical therapy and were followed for three months. Twenty patients required LP shunting, while 20 were successfully managed conservatively. Baseline clinical, ophthalmological, radiological, and CSF opening-pressure parameters were compared, and binary regression analysis identified factors associated with shunting. Results: Patients requiring LP shunting had significantly higher BMI (33.01±3.30 vs. 27.10±2.86 kg/m²; P<0.001) and CSF opening pressure (32.85±7.23 vs. 18.20±4.06 cmH₂O; P<0.001). High-grade papilledema (57.5% vs. 10%; P<0.001) and venous sinus stenosis (50% vs. 10%; P=0.006) were more frequent in the shunt group. In multivariable analysis, BMI (AOR=1.730; P=0.041) and opening pressure (AOR=1.363; P=0.019) were significant. In backward analysis, opening pressure remained independently significant (AOR=1.391; P=0.009), while BMI was borderline (P=0.052). Headache improved significantly in both groups, with no difference in percentage improvement (P=0.409). Conclusion: Elevated CSF opening pressure was the strongest independent predictor of LP shunt requirement. Higher BMI, severe papilledema, and venous sinus stenosis may also help identify patients at risk of conservative treatment failure
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7222875134