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Routine Blood and Cerebrospinal Fluid Markers in Newly Diagnosed Idiopathic Intracranial Hypertension: An Exploratory
Nadja Skadkær Hansen1,2, Isabella Falkenberg Schmidt1,2, Therese Wallentin Steenfos3
1Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark.
Eye and Brain
|March 5, 2026
Summary
Idiopathic intracranial hypertension (IIH) involves higher white blood cell and neutrophil counts in patients, correlating with disease severity. This suggests systemic inflammation plays a role in IIH pathogenesis.
Area of Science:
- Neurology
- Immunology
- Biochemistry
Background:
- Idiopathic intracranial hypertension (IIH) is a condition characterized by increased intracranial pressure and papilledema.
- The precise etiology of IIH remains unclear, despite evidence of metabolic factors.
- Investigating routine blood and cerebrospinal fluid (CSF) markers may offer insights into IIH pathophysiology.
Purpose of the Study:
- To evaluate routine blood and CSF markers in newly diagnosed IIH patients.
- To compare these markers against a control group of "IIH mimics".
Main Methods:
- Prospective cohort study of patients with clinically suspected IIH.
- Comparison of 139 females with confirmed IIH (2013 criteria) to 78 controls.
- Exclusion of secondary causes, pregnancy, relapse, age >50, male sex, and confounding medications.
Main Results:
- IIH patients showed higher plasma leukocytes (p=0.02) and neutrophils (p=0.04), and alkaline phosphatase (p=0.03).
- Lower plasma urea (p=0.04) and CSF protein (p=0.02) were observed in IIH patients.
- Leukocytes and neutrophils correlated with lumbar opening pressure and severe papilledema, independent of BMI or smoking.
Conclusions:
- Newly diagnosed IIH exhibits increased systemic inflammation, linked to disease severity.
- Inflammation appears to be a significant factor in the complex and heterogeneous nature of IIH.
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