Prevalence of elevated intracranial pressure in patients with classical trigeminal neuralgia with overweight and obesity

Abstract

Background: There is a clear association between obesity and Idiopathic Intracranial Hypertension (IIH), a syndrome characterized by increased Intracranial Pressure (ICP). The clinical manifestations of IHH include headache and visual/oculomotor disorders due to the involvement of abducens nerve. Thus far, it has not been widely studied whether affectations by ICP elevation could involve other cranial nerves such as the trigeminal nerve.Objective: The aim of this study is to analyze the prevalence of elevated ICP in patients with BMI ≥ 25 that suffer vascular compression of the trigeminal nerve. Methods: A case series including 19 patients evaluated during a period of 8 months with BMI ≥ 25 and a clinical diagnosis of classic trigeminal neuralgia (TN) who underwent Microvascular Decompression (MVD) surgery is reported. Patients with TN presenting another cause of intracranial hypertension were excluded. The ICP was determined just before MVD surgery by introducing an enteral tube through a 2 mm incision in the dura and measuring the level reached by the CSF. Results: In our series, 42.1% of patients suffered overweight (n = 8), 47.3% grade I obesity (n = 9) and 10.5% grade II obesity (n = 2). The ICP was elevated in 47.4% of patients. Conclusion: IHH is an obesity-related disorder. Patients with BMI ≥ 25 and TN show a high prevalence of ICP. It is important to consider that an obese patient may present high ICP during and after MVD surger